Predictive value of glomerular filtration rate estimated by three FAS formulas for all-cause mortality in patients in coronary care unit
-
摘要: 目的 比较三种FAS公式估算的肾小球滤过率（estimated glomerular filtration rate，eGFR）对冠心病监护室（Coronary Care Unit，CCU）患者全因死亡的预测价值。方法 回顾性分析2014年1月1日至2015年6月1日武汉大学中南医院CCU收治的369例患者的临床资料，使用三种FAS公式分别计算eGFR（eGFRFASScr，eGFRFASCysC，eGFRFASScr-CysC），采用Cox回归分析CCU患者全因死亡的影响因素，绘制受试者工作特征曲线（receiver operating characteristic curve，ROC），评估影响因素对CCU患者全因死亡的预测价值。结果 369例CCU患者中，93例发生全因死亡事件（25.2%）。单因素COX回归分析显示，年龄、发生急性肾损伤（acute kidney injury，AKI）、手术、使用血管活性药物、使用呼吸机、血红蛋白、白蛋白、血清胱抑素C（cystatin C，CysC）、血肌酐（serum creatinine，Scr）、超敏C反应蛋白、急性生理与慢性健康状况（acute physiology and chronic health evaluationⅡ，APACHEⅡ）评分、慢性肾脏病病史、eGFRFASScr、eGFRFASCysC、eGFRFASScr-CysC与CCU患者全因死亡相关（均P<0.05）；多因素COX回归分析显示，eGFRFASCysC（HR=0.960，95%CI：0.928~0.992，P=0.016）是患者全因死亡的独立影响因素。eGFRFASCysC预测CCU患者全因死亡的ROC曲线下面积较大（AUC：0.842，P<0.001）。结论 eGFRFASCysC是CCU患者全因死亡的独立预测因子。Abstract: Objective To compare the predictive value of estimated glomerular filtration rate(eGFR) estimated by three FAS formulas for all-cause mortality in coronary care unit(CCU) patients.Methods From January 1,2014 to June 1,2015,a total of 369 CCU patients were recruited.The values of eGFRFASScr,eGFRFASCysC and eGFRFASScr-CysC were calculated by three FAS formulas.Cox regression analysis was utilized for examining the influencing factors of all-cause mortality and receiver operating characteristic curve(ROC) was plotted for evaluating the predictive value of the influencing factor for all-cause mortality in CCU patients.Results Among them,93(25.2%) had all-cause mortality events.Univariate Cox regression analysis revealed that age,AKI,operation,use of vasoactive drugs,use of breathing machine,hemoglobin(Hb),albumin(Alb),cystatin C(CysC),serum creatinine(Scr),high sensitivity-C reactive protein(hs-CRP),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score,chronic kidney disease history,eGFRFASScr,eGFRFASCysC and eGFRFASScr-CysC were associated with all-cause mortality(P<0.05).And multivariate Cox regression analysis showed that eGFRFASCysC(HR=0.960,95%CI:0.928~0.992,P=0.016) was an independent influencing factor for all-cause mortality in CCU patients.And eGFRFASCysC might predict a larger area under the ROC curve for all-cause mortality in CCU patients.Conclusion eGFRFASCysC is an independent predictor of all-cause mortality in CCU patients.
-
-
[1] Jiao M,Li JT,Zhang Q,et al.Identification of four potential biomarkers associated with coronary artery disease in non-diabetic patients by gene Co-expression network analysis[J].FrontGenet,2020,11:542.DOI: 10.3389/fgene.2020.00542.
[2] Almeida I,Caetano F,Barra S,et al.Estimating glomerular filtration rate in acute coronary syndromes:Different equations,different mortality risk prediction[J].Eur Heart J Acute Cardiovasc Care,2016,5(3):223-230.DOI: 10.1177/2048872615576219.
[3] Rioboo Lestón L,Abu-Assi E,Raposeiras-Roubin S,et al.Prognostic usefulness of an age-adapted equation for renal function assessment in older patients with acute coronary syndrome[J].Eur Heart J Acute Cardiovasc Care,2018,7(8):703-709.DOI: 10.1177/2048872617730040.
[4] Li Z,Ge W,Han CY,et al.Prognostic values of three equations in estimating glomerular filtration rates of patients undergoing Off-pump coronary artery bypass grafting[J].Ther Clin Risk Manag,2020,16:451-459.DOI: 10.2147/TCRM.S248710.
[5] 黄思华,吴锡信.肌酐全年龄阶段新公式在慢性肾脏病患者中的临床应用研究[J].中华危重病急救医学,2018,30(9):877-881.DOI: 10.3760/cma.j.issn.2095-4352.2018.09.011. Huang SH,Wu XX.Clinical application of full age spectrum formula based on serum creatinine in patients with chronic kidney disease[J].Chin Crit Care Med,2018,30(9):877-881.DOI: 10.3760/cma.j.issn.2095-4352.2018.09.011.
[6] Gallo P,de Vincentis A,Pedone C,et al.Prognostic relevance of glomerular filtration rate estimation obtained through different equations in hospitalized elderly patients[J].Eur J Intern Med,2018,54:60-64.DOI: 10.1016/j.ejim.2018.04.001.
[7] Pottel H,Hoste L,Dubourg L,et al.An estimated glomerular filtration rate equation for the full age spectrum[J].Nephrol Dial Transplant,2016,31(5):798-806.DOI: 10.1093/ndt/gfv454.
[8] Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease[J].Am J Cardiol,1983,51(3):606.DOI: 10.1016/s0002-9149(83)80105-2.
[9] Deveci B,Gazi E.Relation between globulin,fibrinogen,and albumin with the presence and severity of coronary artery disease[J].Angiology,2021,72(2):174-180.DOI: 10.1177/0003319720959985.
[10] Rudzik R,Dziedziejko V,Rać ME,et al.Polymorphisms in GP6,PEAR1A,MRVI1,PIK3CG,JMJD1C,and SHH genes in patients with unstable angina[J].Int J Environ Res Public Health,2020,17(20):E7506.DOI: 10.3390/ijerph17207506.
[11] Rivera-Caravaca JM,Ruiz-Nodar JM,Tello-Montoliu A,et al.Disparities in the estimation of glomerular filtration rate according to Cockcroft-gault,modification of diet in renal disease-4,and chronic kidney disease epidemiology collaboration equations and relation with outcomes in patients with acute coronary syndrome[J].J Am Heart Assoc,2018,7(9):e008725.DOI: 10.1161/JAHA.118.008725.
[12] de Rosa R,Morici N,De Servi S,et al.Impact of renal dysfunction and acute kidney injury on outcome in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention[J].Eur Heart J Acute Cardiovasc Care,2020:2048872620920475.DOI: 10.1177/2048872620920475.
[13] Flores-Blanco PJ,López-Cuenca Á,Januzzi JL,et al.Comparison of risk prediction with the CKD-EPI and MDRD equations in non-ST-segment elevation acute coronary syndrome[J].Clin Cardiol,2016,39(9):507-515.DOI: 10.1002/clc.22556.
[14] Lee K,Kim J.Estimated glomerular filtration rate and albuminuria in Korean population evaluated for cardiovascular risk[J].Int Urol Nephrol,2016,48(5):759-764.DOI: 10.1007/s11255-016-1244-9.
[15] Chen Q,Zhang Y,Ding D,et al.Estimated glomerular filtration rate and mortality among patients with coronary heart disease[J/OL].PLoS One,2016,11(8):e0161599.DOI: 10.1371/journal.pone.0161599.
[16] Pottel H,Delanaye P,Schaeffner E,et al.Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C[J].Nephrol Dial Transplant,2017,32(3):497-507.DOI: 10.1093/ndt/gfw425.
[17] Wong Vega M,Swartz SJ,Devaraj S,et al.Elevated serum creatinine:but is it renal failure?[J/OL].Pediatrics,2020,146(1):e20192828.DOI: 10.1542/peds.2019-2828.
[18] Hojs Fabjan T,Penko M,Hojs R.Newer glomerular filtration rate estimating equations for the full age spectrum based on serum creatinine and cystatin C in predicting mortality in patients with ischemic stroke[J].Eur J Intern Med,2018,52:67-72.DOI: 10.1016/j.ejim.2018.02.005.
[19] Zhao MH,Che QQ,Zhang YD,et al.Expression and clinical significance of serum cystatin C in patients with hypertension and coronary heart disease[J].Medicine(Baltimore),2020,99(22):e20029.DOI: 10.1097/MD.0000000000020029.
[20] Melo F,Macedo E,Fonseca Bezerra AC,et al.A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries[J/OL].PloS one,2020,15(1):e226325.DOI: 10.1371/journal.pone.0226325.
[21] Jang SY,Yang DH,Kim HJ,et al.Prognostic Value of Cystatin C-Derived Estimated Glomerular Filtration Rate in Patients with Acute Heart Failure[J].Cardiorenal Med,2020,10(4):232-242.DOI: 10.1159/000504084.
-
期刊类型引用(3)
1. 丁楚，王弦，张琳. 结构化转运准备对冠心病患者离开监护室时焦虑的影响. 国际精神病学杂志. 2025(01): 253-257 . 
百度学术
2. 李同泽，耿斌. 2型糖尿病患者外周血25-(OH)D3及CysC水平与微血管病变的相关性. 中国实用医刊. 2023(11): 61-64 . 百度学术
3. 陈小娟，高飞，王洁琳，郑浩，朱素菲，黄圳婷. sFlt-1/PlGF、CysC、补体C1q在预测子痫前期严重程度中的临床应用价值. 广州医科大学学报. 2022(03): 53-57 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 353
- HTML全文浏览量: 0
- PDF下载量: 246
- 被引次数: 3
下载:
.png)