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首页> 外文期刊>Circulation journal >Beta-Trace Protein and Cystatin C as Predictors of Major Bleeding in Non-ST-Segment Elevation Acute Coronary Syndrome
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Beta-Trace Protein and Cystatin C as Predictors of Major Bleeding in Non-ST-Segment Elevation Acute Coronary Syndrome

机译：β-痕迹蛋白和胱抑素C作为非ST段抬高急性冠脉综合征主要出血的预测因子。

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Background: ?Beta-trace protein (BTP) and cystatin C (CysC) are novel biomarkers of renal function. We assessed the ability of both to predict major bleeding (MB) in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), compared to other renal function parameters and clinical risk scores. Methods and Results: ?We included 273 patients. Blood samples were obtained within 24h of admission. The endpoint was MB. During a follow-up of 760 days (411–1,098 days), 25 patients (9.2%) had MB. Patients with MB had higher concentrations of BTP (0.98mg/L; 0.71–1.16mg/L vs. 0.72mg/L, 0.60–0.91mg/L, P=0.002), CysC (1.05mg/L; 0.91–1.30mg/L vs. 0.90mg/L, 0.75–1.08mg/L, P=0.003), higher CRUSADE score (39±16 points vs. 29±15 points, P=0.002) and lower estimated glomerular filtration rate (eGFR; 66±27 vs. 80±30ml·min–1·1.73m–2, P=0.02) than patients without MB; there was no difference in creatinine level between the groups (P=0.14). After multivariable adjustment, both were predictors of MB, while eGFR and creatinine did not achieve statistical significance. Among subjects with eGFR >60ml·min–1·1.73m–2, those with elevated concentrations of both biomarkers had a significantly higher risk for MB. Net reclassification indexes from the addition of BTP and CysC to CRUSADE risk score were 38% and 21% respectively, while the relative integrated discrimination indexes were 12.5% and 3.8%. Conclusions: ?Among NSTE-ACS patients, BTP and CysC were superior to conventional renal parameters for predicting MB, and improved clinical stratification for hemorrhagic risk.??( Circ J ?2013; 77: 2088–2096)
机译：背景：β-痕量蛋白（BTP）和半胱氨酸蛋白酶抑制剂C（CysC）是肾功能的新型生物标志物。与其他肾功能参数和临床风险评分相比，我们评估了两者预测非ST段抬高急性冠状动脉综合征（NSTE-ACS）患者大出血（MB）的能力。方法和结果：我们纳入了273例患者。入院后24小时内取血样。端点是MB。在760天（411-1,098天）的随访中，有25名患者（9.2％）患有MB。 MB患者的BTP浓度较高（0.98mg / L; 0.71–1.16mg / L vs. 0.72mg / L，0.60–0.91mg / L，P = 0.002），CysC（1.05mg / L; 0.91-1.30mg / L vs. 0.90mg / L，0.75–1.08mg / L，P = 0.003，CRUSADE评分较高（39±16分与29±15分，P = 0.002），肾小球滤过率估计较低（eGFR; 66）与没有MB的患者相比，±27 vs. 80±30ml·min –1 ·1.73m –2 ，P = 0.02）;两组之间的肌酐水平无差异（P = 0.14）。经过多变量调整后，两者都是MB的预测指标，而eGFR和肌酐没有达到统计学意义。 eGFR> 60ml·min –1 ·1.73m –2 的受试者中，两种生物标志物浓度升高的受试者患MB的风险均显着更高。将BTP和CysC添加到CRUSADE风险评分中的净重分类指数分别为38％和21％，而相对综合判别指标为12.5％和3.8％。结论：在NSTE-ACS患者中，BTP和CysC在预测MB方面优于常规肾脏指标，并改善了出血风险的临床分层。（Circ J，2013; 77：2088-2096）。

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