Relationship between kynurenine/tryptophan ratio and short-term prognosis in elderly inpatients with heart failure
10.3969/j.issn.1009-0126.2024.10.004
- VernacularTitle:老年心力衰竭住院患者犬尿氨酸和色氨酸与短期预后的关系探索
- Author:
Fei XIAO
1
;
Qingfang LIU
;
Chunxiang ZHOU
Author Information
1. 410005 长沙市第一医院全科医学科
- Keywords:
heart failure;
kynurenine;
tryptophan;
prognosis
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(10):1134-1137
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the fluctuation of kynuridine/tryptophan ratio and its relation-ship with short-term prognosis in hospitalized patients with HF.Methods A total of 150 elderly HF patients admitted to our hospital from December 2020 to December 2022 were enrolled,and according to their clinical outcomes in 6 months after discharge,they were divided into poor prog-nosis group(n=48)and good prognosis group(n=102).The concentrations of kynurenine and tryptophan in serum were determined by liquid chromatography-tandem mass spectrometry.The kynuridine/tryptophan ratio at admission and discharge was compared between the two groups.ROC curve was plotted to evaluate the value of the ratio in predicting the short-term prognosis in the patients.Logistic regression analysis was used to identify the influencing factors for adverse events in these inpatients in 6 months after discharge.Results The poor prognosis group had sig-nificantly lower levels of TC,BNP and BUN than the good prognosis group(P＜0.05).The kynuridine/tryptophan ratio was obviously lower at discharge than at admission in both groups(P＜0.01),and the ratio in the poor prognosis group at discharge was notably higher than that in the good prognosis group(P＜0.01).ROC curve analysis showed that the AUC value of kynuri-dine/tryptophan ratio at admission and discharge in predicting short-term prognosis of the HF in-patients was 0.863(95％CI:0.803-0.924)and 0.701(95％CI:0.602-0.801),respectively,with the predictive performance of the ratio at discharge higher than that at admission(P＜0.05).Mul-tivariate logistic regression analysis indicated that TC(OR=0.696,95％CI:0.501-0.965),BNP(OR=1.530,95％CI:1.092-2.143),BUN(OR=1.740,95％CI:1.077-2.813)and the kynuri-dine/tryptophan ratio at discharge(OR=2.280,95％CI:1.093-4.754)were the influencing fac-tors of adverse events in the elderly HF inpatients in 6 months after discharge(P＜0.05).Conclu-sion Kynurenine/tryptophan ratio is an independent risk factor for short-term poor prognosis in hospitalized HF patients,and it can effectively predict short-term prognosis of the patients.
