1.Prognostic value of CHR after percutaneous coronary intervention in patients with stable coronary artery disease
Shengbiao ZHAO ; Wei WANG ; Yang LIU ; Junjun LIU
Chongqing Medicine 2024;53(21):3268-3273
Objective To investigate the clinical value of C reactive protein(CRP)to high-density lipo-protein-cholesterol(HDL-C)ratio(CHR)in predicting the all-cause mortality after percutaneous coronary in-tervention(PCI)in the patients with stable coronary artery disease(SCAD).Methods A total of 189 patients with SCAD undergoing PCI admitted and treated in this hospital were selected as the study subjects.The pa-tients'data were collected,including the history of hypertension,diabetes,hyperlipidemia,smoking,drug use,etc.,and the relevant indicators such as electrocardiogram,echocardiography,liver function,renal function,blood lipids,blood glucose,Hb,CRP,post-discharge drug treatment regimen and out-of-hospital follow-up re-sults were recorded.The CHR level of the patients was calculated,and the receiver operating characteristic(ROC)curve of CHR was plotted,the grouping was performed according to the cutoff value and the clinical data were compared between the two groups.The Kaplan-Meier survival curve and multivariate Cox risk mod-el were used to analyze the relationship between CHR and all-cause mortality events.Results The follow-up time was 730 d,and 16 cases of all-cause death occurred during the follow-up period.The area under the curve(AUC)of CHR for predicting the all-cause mortality was 0.833(95%CI:0.735-0.930,P<0.001),and the cut-off value was 2.446.The grouping was performed according to CHR=2.446,there were 52 cases in the high CHR group(CHR≥2.446)and 137 cases in the low CHR group(CHR<2.446).The diastolic blood pressure level,CRP level and proportion of all-cause mortality in the high CHR group were higher than those in the low CHR group,and the proportion of diabetes mellitus,Hb level,TC level and HDL-C level were lower than those in the low CHR group,and the differences were statistically significant(P<0.05).The results of Kaplan-Meier survival analysis showed that the incidence rate of all-cause mortality in the high CHR group was higher than that in the low CHR group(Log-Rank x2=26.127,P<0.001).The multivariate Cox regres-sion analysis results showed that CHR was the independent influencing factor of the occurrence of all-cause mortality after adjusting age,gender,diastolic blood pressure,diabetes mellitus,left ventricular ejection frac-tion,Hb and TC(P<0.05).Conclusion CHR is an independent predictive factor of all-cause mortality after PCI in the patients with SCAD,and clinic needs to pay attention to.
2.Clinical value of uric acid-to-albumin ratio on prognosis of patients with heart failure
Shengbiao ZHAO ; Junjun LIU ; Liansheng WANG ; Qiming WANG ; Yang LIU ; Wei WANG
Chongqing Medicine 2024;53(13):1994-1999
Objective To investigate the clinical value of uric acid(UA)to albumin(Alb)ratio(UAR)in predicting the prognosis of the patients with heart failure.Methods A total of 1 893 patients with heart failure and complete clinical data in the Chinese Heart Failure Database were selected as the clinical research subjects for conducting the retrospective cohort analysis.The general clinical data,coagulation routine,tropo-nin Ⅰ(cTnⅠ),cardiac enzyme profile,liver function,B-type brain natriuretic peptide(BNP),uric acid(UA)and left ventricular ejection fraction in echocardiography in the study subjects were collected to calculate UAR.Ac-cording to the receiver operating characteristic(ROC)curve,the optimal cut-off value of UAR was selected as 17.48.Then the subjects were divided into the low UAR group(UAR<17.48,n=1 525)and high UAR group(UAR≥17.48,n=368).The clinical data were compared between the two groups,and the effect of UAR on the all-cause mortality in the patients with heart failure was evaluated by the binary logistic regres-sion analysis.Results The follow up time in the patients was 90 d,and 37 cases(2.0%)of all-cause death oc-curred during the follow up period.The proportion of males,proportion of cardiac function grade Ⅳ,propor-tion of myocardial infarction,levels of uric acid,D-dimer,creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),alanine aminotransferase(ALT),glutamyl transpeptidase(GGT),alkaline phosphatase(AKP)and BNP in the high UAR group were higher than those in the low UAR group,while the pulse,systolic pressure,diastolic pressure,proportions of heart function grade Ⅱ and grade Ⅲ and ALB level were lower than those in the UAR group,and the differences were statistically significant(P<0.05).The ROC curve analysis results showed that the area under the curve of UAR for assessing the all-cause death occurrence in heart failure was 0.715(95%CI:0.626-0.804,P<0.001),the sensitivity was 56.8%and the specificity was 81.4%;the binary logistic regression analysis results showed that the incidence rate of all-cause mortality in the high UAR group was 1.09 times higher than that in the low UAR group(OR=1.09,95%CI:1.02-1.20,P=0.017).Conclusion UAR could serve as an independent predictive fac-tor of all-cause death occurrence in heart failure,which needs clinic to pay attention.
3.Impact of hemoglobin on all-cause mortality risk in elderly patients with stable coronary artery disease after interventional therapy
Yang LIU ; Zuonian ZHANG ; Zhiye WANG ; Mengyuan NI ; Zhaomin LU ; Lihua ZHANG ; Shengbiao ZHAO ; Junjun LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(5):513-517
Objective To investigate the impact of hemoglobin(Hb)level on the risk of all-cause mortality in elderly patients with stable coronary artery disease(SCAD)treated by percutaneous coronary intervention(PCI).Methods A retrospective cohort study was conducted on 195 elderly SCAD patients treated by PCI in our hospital from June 2016 to December 2017,a total of 180 case were followed up.They were divided into four groups based on quartiles of Hb levels:Q1 group[≤122(108.28±12.53)g/L,n=47],Q2 group[122<Hb≤137(130.07±4.33)g/L,n=43],Q3 group[137<Hb≤148(142.67±3.10)g/L,n=46],and Q4 group[>148(158.36±8.50)g/L,n=44].Their clinical data were collected and compared among the groups.All patients were followed up,with all-cause mortality as endpoint.Cox regression analysis was used to evaluate the impact of Hb level on all-cause mortality in elderly SCAD patients treated by PCI.Results For the 180 patients with complete follow-up,the median follow-up time was 703(415,1121)d,and the incidence of all-cause mortality was 10.00%(totally 18 deaths).And the incidence was 25.50%(12 deaths),7.00%(3 death),4.30%(2 deaths)and 2.30%(1 death)in Q1,Q2,Q3,and Q4 groups,respectively,with statistically significant differences(P<0.01).Univariate Cox regression analysis showed age was a risk factor for all-cause death(P<0.01),while Hb level,BMI,smoking history,dyslipidemia,and aspirin use were a risk facotr for all-cause death(P<0.05,P<0.01).Further multivariate Cox regression analysis revealed Hb level was a risk facotr for all-cause death(HR=0.96,95%CI:0.93-0.99,P<0.01).The risk of all-cause mortality was 3.68 times higher in the Q1 group than the Q2 group(HR=3.68,95%CI:1.01-13.45,P<0.05),and there was no correlation in the incidence between the Q3 and Q4 groups(P>0.05).Conclusion Low Hb level is an independent predictor for all-cause mortality in elderly SCAD pa-tients after PCI.
4.Prognostic significance of anemia in elderly patients with stable coronary artery disease treated by percutaneous coronary intervention
Yang LIU ; Zhiye WANG ; Zuonian ZHANG ; Mengyuan NI ; Zhaomin LU ; Wei WANG ; Lihua ZHANG ; Shengbiao ZHAO ; Junjun LIU
Chinese Journal of Geriatrics 2023;42(11):1280-1284
Objective:To investigate the prognostic significance of anemia in elderly patients with stable coronary artery disease treated by percutaneous coronary intervention(PCI).Methods:In this retrospective cohort study, 180 patients with stable coronary artery disease aged ≥60 years undergone percutaneous coronary intervention and with complete clinical data, admitted to Nanjing Meishan Hospital between June 2016 and December 2017, were selected.Baseline clinical data of the patients were collected, including hemoglobin, C-reactive protein, lipids, fasting glucose, glycated hemoglobin, blood creatinine, and left ventricular ejection fraction on cardiac color ultrasound.The endpoints of the follow-up included major adverse cardiac events(MACE), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke.According to the hemoglobin level, participants were divided into an anemia group(n=32)and a non-anemia group(n=148). Clinical data of the two groups were compared, and the Kaplan-Meier method and multivariate analysis with the Cox regression method were used to evaluate the effect of anemia on the occurrence of MACE in elderly patients with stable coronary artery disease treated by PCI.Results:The median duration of the follow-up of the 180 patients was 702.5 days and MACE occurred in 27(15.0%). Compared with the non-anemia group, the anemia group had a higher age, C-reactive protein level and MACE ratio, lower levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol and the glomerular filtration rate, and higher proportions of patients with smoking history and patients with dyslipidemia( P<0.05). Kaplan-Meier curves suggested that the incidence of MACE in the anemia group was higher than that in the non-anemia group[37.5%(12/32) vs.10.1%(15/148), P<0.05]. Multivariate analysis with the Cox regression method showed that the risk of MACE in the anemia group was 2.91 times higher than that in the non-anemia group( HR=2.91, 95% CI: 1.13-7.48, P<0.05). Conclusions:Anemia is an independent predictor of MACE in elderly patients with stable coronary artery disease after PCI.