影响心脏手术后生存率的因素

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摘要译文（供参考）

可溶性尿激酶纤溶酶原激活剂受体与择期心脏手术的生存率

背景：

本研究研究了可溶性尿激酶纤溶酶原激活物受体（suPAR）在心脏手术患者中的预后价值，并计算了包括suPAR、N-末端前B型钠尿肽（NT-proBNP）和年龄的简化生物标志物评分。

方法和结果：

对478名接受择期心脏手术的患者进行了生物标志物评估。 中位随访4.2年后，共有72名（15.1%）患者死亡。 在校正EuroScoreII后的多变量Cox回归模型中，SuPAR、NT-proBNP和年龄是死亡率的独立预测因素。 然后，我们计算了一个包括年龄、suPAR和NT-proBNP的简化生物标志物评分，与EuroScoreII相比，该评分具有更高的预后价值（Harrel的C值为0.76 vs 0.72；差异P值=0.02）。 除长期死亡率外，生物标志物得分还具有预测一年死亡率和因心力衰竭住院的出色表现。

结论：

生物标志物suPAR和NT-proBNP与心脏手术患者的死亡率密切相关。 仅包含3个变量（年龄、suPAR和NT-proBNP）的简化生物标志物评分在中长期结局以及因心力衰竭住院方面表现优于已建立的EuroScoreII。 因此，在临床实践中整合已建立的和即将到来的生物标志物可以为心脏手术提供更好的决策支持。

关键词：

EuroScoreII；生物标志物；心脏外科；风险预测；suPAR。

原文摘要

Soluble urokinase plasminogen activator receptor and survival in elective cardiac surgery

Background: The study investigated the prognostic value of soluble urokinase plasminogen activator receptor (suPAR) in patients undergoing cardiac surgery and calculated a simplified biomarker score comprising suPAR, N-terminal pro B-type natriuretic peptide (NT-proBNP) and age.

Methods and results: Biomarkers were assessed in a cohort of 478 patients undergoing elective cardiac surgery. After a median follow-up of 4.2 years, a total of 72 (15.1%) patients died. SuPAR, NT-proBNP and age were independent prognosticators of mortality in a multivariable Cox regression model after adjustment for EuroScoreII. We then calculated a simplified biomarker score comprising age, suPAR and NT-proBNP, which had a superior prognostic value compared to EuroScoreII (Harrel´s C of 0.76 vs 0.72; P for difference=0.02). Besides longterm mortality, the biomarker score had an excellent performance predicting one-year mortality and hospitalization due to heart failure.

Conclusion: The biomarker suPAR and NT-proBNP were strongly and independently associated with mortality in patients undergoing cardiac surgery. A simplified biomarker score comprising only 3 variables (age, suPAR and NT-proBNP) performed better than the established EuroScoreII with respect to intermediate and long-term outcome as well as hospitalization due to heart failure. As such, integration of established and upcoming biomarkers in clinical practice may provide improved decision support in cardiac surgery.

Keywords: EuroScoreII; biomarker; cardiac surgery; risk prediction; suPAR.

日积月累

urokinase

尿激酶

cardiac surgery

心脏外科，心外科；心脏手术

plasminogen

血纤维蛋白溶酶原；血浆酶原

a total of

总数为

compared to

与…相比;比拟，比作

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本微信公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：Michel.米萱

校对：Mijohn.米江

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