■动脉硬化是心血管疾病的主要致病因素。本研究旨在探讨急性失代偿性心力衰竭(ADHF)患者血浆致动脉粥样硬化指数(AIP)与30天死亡率的相关性。
■从2019年至2022年的江西急性失代偿性心力衰竭1(JX-ADHF1)队列中招募的1,248例ADHF患者被选入本研究。主要结果是30天死亡率。多变量Cox回归,受限三次样条(RCS),采用分层分析评估ADHF患者AIP与30天死亡率之间的关系.中介模型用于探索性分析炎症的作用,氧化应激,和营养在AIP和ADHF患者30天死亡率之间的关联。
■在30天随访期间,42例(3.37%)ADHF患者死亡。对应于AIP四分位数的死亡率如下:Q1:1.28%,Q2:2.88%,Q3:2.88%,Q4:6.41%。多变量Cox回归显示高AIP与ADHF患者30天死亡率呈正相关[危险比(HR)3.94,95%置信区间(CI):1.08-14.28],独立于年龄,性别,心力衰竭类型,心功能分类,和合并症。值得注意的是,在第四个四分位数之前,AIP(<0.24)和30天死亡率之间存在U形曲线关联。ADHF患者30天死亡风险最低,AIP为-0.1左右。此外,中介分析提示炎症和营养对与AIP相关的ADHF患者30天死亡率有显著的中介作用,其中炎症约占24.29%,营养约占8.16%的调解作用。
■这项回顾性队列分析首次揭示了AIP与ADHF患者30天死亡率之间的关联。根据我们的发现,从医学角度来看,维持ADHF患者的AIP在-0.1左右对于改善不良预后至关重要.此外,对于高AIP的ADHF患者,重要的是要评估,如有必要,加强营养支持和抗炎治疗。
UNASSIGNED: Arteriosclerosis is a primary causative factor in cardiovascular diseases. This study aims to explore the correlation between the atherogenic index of plasma (AIP) and the 30-day mortality rate in patients with acute decompensated heart failure (ADHF).
UNASSIGNED: A total of 1,248 ADHF patients recruited from the Jiangxi-Acute Decompensated Heart Failure1 (JX-ADHF1) cohort between 2019 and 2022 were selected for this study. The primary outcome was the 30-day mortality rate. Multivariable Cox regression, restricted cubic splines (RCS), and stratified analyses were utilized to assess the relationship between AIP and the 30-day mortality rate in ADHF patients. Mediation models were employed for exploratory analysis of the roles of inflammation, oxidative stress, and nutrition in the association between AIP and the 30-day mortality rate in ADHF patients.
UNASSIGNED: During the 30-day follow-up, 42 (3.37%) of the ADHF patients died. The mortality rates corresponding to the quartiles of AIP were as follows: Q1: 1.28%, Q2: 2.88%, Q3: 2.88%, Q4: 6.41%. The multivariable Cox regression revealed a positive correlation between high AIP and the 30-day mortality rate in ADHF patients [Hazard ratio (HR) 3.94, 95% confidence interval (CI): 1.08-14.28], independent of age, gender, heart failure type, cardiac function classification, and comorbidities. It is important to note that there was a U-shaped curve association between AIP (<0.24) and the 30-day mortality rate before the fourth quartile, with the lowest 30-day mortality risk in ADHF patients around an AIP of -0.1. Furthermore, mediation analysis suggested significant mediating effects of inflammation and nutrition on the 30-day mortality rate in ADHF patients related to AIP, with inflammation accounting for approximately 24.29% and nutrition for about 8.16% of the mediation effect.
UNASSIGNED: This retrospective cohort analysis reveals for the first time the association between AIP and the 30-day mortality rate in ADHF patients. According to our findings, maintaining an AIP around -0.1 in ADHF patients could be crucial for improving poor prognoses from a medical perspective. Additionally, for ADHF patients with high AIP, it is important to assess and, if necessary, enhance nutritional support and anti-inflammatory treatment.