Direct Bilirubin, but not Indirect Bilirubin, is Associated with Short-term Adverse Events in HFpEF.

IF 3.8 4区医学 Q2 GENETICS & HEREDITY

Current gene therapy Pub Date : 2024-01-01 DOI:10.2174/0115665232273115240102043640

Sunying Wang, Yan Chen, Hanghao Ma, Yuwei Wang, Manqing Luo, Xianwei Xie, Qingyong Yang, Kaijin Lin, Meihua Lin, Lin Lin, Ping Chen, Qiaowen Zheng, Fuqing Sun

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引用次数: 0

Abstract

Objective: Abnormal live function tests have been identified as independent risk factors for ominous prognosis in patients with heart failure. However, most of the previous studies have failed to determine the contribution of direct bilirubin (DBIL) and indirect bilirubin (IBIL) separately. Hence, we aimed to explore whether DBIL or IBIL is correlated with the prognosis of heart failure with preserved ejection fraction (HFpEF).

Methods: A total of 19837 patients were hospitalized for HFpEF between January 2012 and January 2022 in Fuqing City Hospital affiliated with Fujian Medical University. The primary endpoint was in-hospital all-cause mortality. Secondary endpoints included in-hospital cardiovascular mortality and 30-day re-admission for heart failure.

Results: Univariable analysis indicated that patients with elevated DBIL or IBIL were exposed to a higher risk of mortality and re-admission. However, in multivariable models, both ln-transformed DBIL and TBIL, but not IBIL, were independent risk factors for in-hospital all-cause mortality (hazard ratio (HR)=1.796, 95% confidential interval (CI)=1.477-2.183, P<0.001; HR=1.854, 95% CI=1.461-2.352, P.0.001; HR=1.161, 95% CI=0.959-1.407, P=0.126) and in-hospital cardiovascular mortality (HR=1.831, 95% CI=1.345-2.492, P.0.001; HR=1.899, 95% CI=1.300-2.773, P=0.001; HR=1.145, 95% CI=0.841-1.561, P=0.389). Only DBIL remained independently associated with 30-day readmission for heart failure (HR=1.361, 95% CI=1.036-1.787, P=0.027). Adding ln-transformed DBIL to model 1 increased its discriminatory capacity (C-statistic: 0.851 to 0.869, respectively), whereas adding ln-transformed IBIL yielded little increment (C-statistic: 0.851 to 0.852, respectively).

Conclusion: DBIL, but not IBIL, was associated with short-term ominous prognosis in patients with HFpEF. Hence, DBIL may be the superior predictor for prognosis in HFpEF.

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直接胆红素（而非间接胆红素）与高胆红素血症患者的短期不良事件有关。

目的：活体功能检查异常已被确定为心力衰竭患者预后不佳的独立风险因素。然而，以往的大多数研究未能分别确定直接胆红素（DBIL）和间接胆红素（IBIL）的贡献。因此，我们旨在探讨直接胆红素（DBIL）或间接胆红素（IBIL）是否与射血分数保留型心力衰竭（HFpEF）的预后相关。研究方法2012年1月至2022年1月期间，福建医科大学附属福清市医院共收治19837例HFpEF住院患者。主要终点是院内全因死亡率。次要终点包括院内心血管死亡率和30天心衰再入院率。研究结果单变量分析表明，DBIL或IBIL升高的患者面临更高的死亡率和再入院风险。然而，在多变量模型中，ln 变形的 DBIL 和 TBIL（而非 IBIL）是院内全因死亡率的独立危险因素[危险比（HR）=1.796，95% 置信区间（CI）=1.477-2.183，P＜0.001；HR=1.854，95% CI=1.461-2.352，P＜0.001；HR=1.161，95% CI=0.959-1.407，P=0.126]和院内心血管死亡率（HR=1.831，95% CI=1.345-2.492，P＜0.001；HR=1.899，95% CI=1.300-2.773，P=0.001；HR=1.145，95% CI=0.841-1.561，P=0.389）。只有 DBIL 仍与心衰 30 天再入院独立相关（HR=1.361，95% CI=1.036-1.787，P=0.027）。在模型 1 中加入 ln 变形的 DBIL 增加了其判别能力（C 统计量：分别为 0.851 至 0.869），而加入 ln 变形的 IBIL 则几乎没有增加（C 统计量：分别为 0.851 至 0.852）。结论DBIL 而非 IBIL 与 HFpEF 患者的短期预后不佳有关。因此，DBIL 可能是预测 HFpEF 预后的较佳指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current gene therapy 医学-遗传学

CiteScore

6.70

自引率

2.80%

发文量

期刊介绍： Current Gene Therapy is a bi-monthly peer-reviewed journal aimed at academic and industrial scientists with an interest in major topics concerning basic research and clinical applications of gene and cell therapy of diseases. Cell therapy manuscripts can also include application in diseases when cells have been genetically modified. Current Gene Therapy publishes full-length/mini reviews and original research on the latest developments in gene transfer and gene expression analysis, vector development, cellular genetic engineering, animal models and human clinical applications of gene and cell therapy for the treatment of diseases. Current Gene Therapy publishes reviews and original research containing experimental data on gene and cell therapy. The journal also includes manuscripts on technological advances, ethical and regulatory considerations of gene and cell therapy. Reviews should provide the reader with a comprehensive assessment of any area of experimental biology applied to molecular medicine that is not only of significance within a particular field of gene therapy and cell therapy but also of interest to investigators in other fields. Authors are encouraged to provide their own assessment and vision for future advances. Reviews are also welcome on late breaking discoveries on which substantial literature has not yet been amassed. Such reviews provide a forum for sharply focused topics of recent experimental investigations in gene therapy primarily to make these results accessible to both clinical and basic researchers. Manuscripts containing experimental data should be original data, not previously published.