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首页> 外文期刊>Clinical Interventions in Aging >The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure
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The Additional Prognostic Value of Ghrelin for Mortality and Readmission in Elderly Patients with Acute Heart Failure

机译：急性心力衰竭老年患者死亡率和入伍的额外预后价值

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Purpose: To evaluate the prognostic value of ghrelin, a growth hormone-releasing peptide, for mortality and readmission in elderly patients with acute heart failure (AHF). Patients and Methods: We measured plasma ghrelin and pro B-type natriuretic peptide (NT-proBNP) levels upon emergency admission in 241 prospectively recruited elderly AHF patients (61.0% men). The outcomes were all-cause mortality and/or readmission due to heart failure (HF). Multivariate Cox proportional hazards regression analyses were used to evaluate the prognostic value of ghrelin. Discrimination, calibration, and reclassification indices were compared between models, with or without ghrelin. Results: During 1.2 years of follow-up, we observed 90 events (57 deaths and 33 readmissions due to HF). Plasma ghrelin levels were significantly elevated in elderly AHF patients, when compared to healthy control subjects (P 0.001). Patients with events had significantly higher baseline ghrelin levels, when compared to those without (P 0.001). Ghrelin levels were positively correlated with NT-proBNP levels and HF severity, whereas they were negatively correlated with nutritional status (all P 0.05). Log transformed ghrelin levels were independently associated with AHF events (hazard ratio = 2.64, 95% confidence interval = 1.11– 6.25, P = 0.028). The incorporation of ghrelin into the reference model, or reference with the NT-proBNP model, both improved C-statistics (from 0.742– 0.780 and 0.836– 0.857; P = 0.074 and 0.044, respectively), resulting in an improvement in net reclassification index (14.42% and 10.45%, P = 0.020 and 0.025, respectively), and integrated discrimination index (5.64% and 3.60%, both P 0.001). Patients who displayed the above NT-proBNP and ghrelin median levels had a markedly higher risk of AHF adverse events (P 0.001). Conclusion: Plasma ghrelin is an independent predictor of adverse events in elderly AHF patients. Ghrelin may provide additional value to clinical parameters or NT-proBNP for prognostic risk stratification in AHF.
机译：目的：评估Ghrelin，一种生长激素释放肽的预后价值，用于老年急性心力衰竭（AHF）的老年患者死亡率和再入患者。患者及方法：我们在241名前瞻性招募的老年AHF患者（61.0％）中测量血浆Ghrelin和Pro B型利钠肽（NT-ProPNP）水平。结果是由于心力衰竭（HF）引起的死亡率和/或入院。多变量Cox比例危害回归分析用于评估Ghrelin的预后价值。在模型，有或没有Ghrelin之间比较歧视，校准和重新分类指数。结果：在1.2年后续后，我们观察了90例事件（57人死亡和33个由于HF）。与健康对照对象相比，老年AHF患者血浆Ghrelin水平显着升高（P <0.001）。与没有（P <0.001）的人相比，事件患者的基线GHRELIN水平明显高。 Ghrelin水平与NT-ProPNP水平和HF严重程度正相关，而它们与营养状况负相关（所有P <0.05）。 Log转化的Ghrelin水平与AHF事件独立相关（危险比= 2.64,95％置信区间= 1.11-6.25，P = 0.028）。将Ghrelin掺入参考模型，或参考NT-probnp模型，包括改进的C统计（0.742-0.780和0.836- 0.857; P = 0.074和0.044），导致净重估指数的改善（14.42％和10.45％，P = 0.020和0.025），综合鉴别指数（5.64％和3.60％，P <0.001）。展示上述NT-ProPNP和Ghrelin中位水平的患者具有明显更高的AHF不良事件风险（P <0.001）。结论：血浆Ghrelin是老年AHF患者不良事件的独立预测因子。 Ghrelin可以为AHF中的预后风险分层提供额外的临床参数或NT-probnp。

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