血小板分布宽度与成人心血管死亡率相关

Benedetta Izzi, Simona Costanzo, Alessandro Gialluisi, Amalia De Curtis, Sara Magnacca, Teresa Panzera, Augusto Di Castelnuovo, Maria Benedetta Donati, Chiara Cerletti, Marc F. Hoylaerts, Giovanni De Gaetano, Licia Iacoviello, *on behalf of The Moli-sani Study Investigators
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Baseline PDW measurements were categorized in tertiles, the lowest acting as the reference. A multivariable Cox-proportional hazard model was used to estimate the association between PDW and mortality. Over a median follow-up of 11.6 years (interquartile range 10.7-12.5), 1,535 deaths [37.7% cardiovascular disease (CVD) and 36.5% cancer] were ascertained. As compared to those in the first PDW tertile (14.6-16.0 fL), individuals within the highest tertile (16.6-20.4 fL) had an increased risk of all-cause [hazard ratios (HR):1.20; 95% CI: 1.04-1.37] and CVD mortality (HR:1.29; 1.03-1.62). No association between PDW and cancer mortality was found in the whole sample. Subgroup analyses by two age classes (35-65y, ≥65y) showed that the association of PDW with both all-cause and cancer mortality was more apparent in the elderly (HR:1.34; 1.14-1.58, P for interaction =0.028 and HR:1.37; 1.01-1.85, P for interaction =0.020, respectively). 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引用次数: 0

摘要

血小板分布宽度(PDW)是血小板大小异质性的标志,用于读出导致血小板产生和破坏的过程,最近被报道用于标记血小板活化变异性。由于血小板参与许多急慢性疾病的发病机制,我们评估了PDW作为全因和病因特异性死亡率的预测因子。对Moli-sani研究队列中无血液病史的17,334名参与者(52%为女性,平均年龄55.6±12岁)进行纵向分析。基线PDW测量值以瓦特为单位进行分类,最低的瓦特作为参考。采用多变量cox -比例风险模型估计PDW与死亡率之间的关系。在中位随访11.6年(四分位数范围10.7-12.5)期间,确定了1,535例死亡,其中37.7%为心血管疾病(CVD), 36.5%为癌症。与第一等级(14.6 ~ 16.0 fL)的个体相比,最高等级(16.6 ~ 20.4 fL)个体的全因风险增加[风险比(HR):1.20;95% CI: 1.04-1.37]和心血管疾病死亡率(HR:1.29;1.03 - -1.62)。在整个样本中没有发现PDW和癌症死亡率之间的关联。两个年龄组(35-65岁,≥65岁)的亚组分析显示,PDW与全因死亡率和癌症死亡率的相关性在老年人中更为明显(HR:1.34;1.14-1.58,交互作用P =0.028, HR:1.37;1.01 ~ 1.85,交互作用P =0.020)。我们得出结论,pdw相关的CVD死亡风险增加可能与血小板激活、产生或破坏的加速/改变有关,从而导致几种临床状况和死亡。在老年人中,PDW与全因死亡率和癌症死亡率的关系应进一步调查。*Moli-sani调查员指导委员会:Licia Iacoviello, Giovanni de Gaetano, Maria Benedetta Donati。科学秘书处:Marialaura Bonaccio、Americo Bonanni、Chiara Cerletti、Simona Costanzo、Amalia De Curtis、Augusto Di Castelnuovo、Alessandro Gialluisi、Francesco Gianfagna、Mariarosaria Persichillo、Teresa Di Prospero。安全和伦理委员会:Jos Vermylen, Renzo Pegoraro, Antonio Spagnolo。外部活动评审委员会:Deodato Assanelli, Livia Rago。基线和随访数据管理:Simona Costanzo, Marco Olivieri, Teresa Panzera。数据分析:奥古斯托·迪·卡斯泰尔诺沃,玛丽亚诺拉·博纳乔,西蒙娜·科斯坦佐,西蒙娜·埃斯波西托,亚历山德罗·贾卢西,弗朗西斯科·吉安法尼亚,萨巴蒂诺·奥兰迪,艾米利亚·鲁杰罗,阿方西娜·蒂罗齐。生物库,分子和基因实验室:Amalia De Curtis, Sara Magnacca, Fabrizia Noro, Alfonsina Tirozzi。招聘人员:Mariarosaria persichilo, Francesca Bracone, Teresa Panzera。通讯和新闻处:Americo Bonanni。区域机构:礼炮总局-莫利塞区;莫利塞地区卫生机构;莫利塞环境保护区域机构;Molise Dati Spa;莫利塞地区人口统计办事处。医院:Ospedale A. Cardarelli, Campobasso;意大利威尼斯Ospedale;圣蒂莫特奥,特尔莫利(CB);Venafro的Ospedale Ss. Rosario (IS);Ospedale Vietri, Larino (CB);Ospedale San francisco Caracciolo, agonne (IS);Casa di Cura Villa Maria, Campobasso;Campobasso的Ospedale Gemelli Molise;IRCCS Neuromed, Pozzilli (IS),意大利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Platelet distribution width is associated with cardiovascular mortality in an adult general population
Platelet distribution width (PDW), a marker of platelet size heterogeneity used as a readout of processes leading to platelet production and destruction, was recently reported to tag platelet activation variability. As platelets participate in the pathogenesis of many acute and chronic diseases, we evaluated PDW as a predictor of all-cause and cause-specific mortality. Longitudinal analysis was performed on 17,334 participants (52% women, mean age 55.6±12 years) in the Moli-sani study cohort, without a history of hematological diseases. Baseline PDW measurements were categorized in tertiles, the lowest acting as the reference. A multivariable Cox-proportional hazard model was used to estimate the association between PDW and mortality. Over a median follow-up of 11.6 years (interquartile range 10.7-12.5), 1,535 deaths [37.7% cardiovascular disease (CVD) and 36.5% cancer] were ascertained. As compared to those in the first PDW tertile (14.6-16.0 fL), individuals within the highest tertile (16.6-20.4 fL) had an increased risk of all-cause [hazard ratios (HR):1.20; 95% CI: 1.04-1.37] and CVD mortality (HR:1.29; 1.03-1.62). No association between PDW and cancer mortality was found in the whole sample. Subgroup analyses by two age classes (35-65y, ≥65y) showed that the association of PDW with both all-cause and cancer mortality was more apparent in the elderly (HR:1.34; 1.14-1.58, P for interaction =0.028 and HR:1.37; 1.01-1.85, P for interaction =0.020, respectively). We conclude that PDW-associated increase in CVD mortality risk could be related to accelerated/altered activation, production, or destruction of platelets, leading to several clinical conditions and death. In the elderly, PDW involvement in all-cause and cancer mortality should be further investigated. *Moli-sani investigatorsSteering committee: Licia Iacoviello, Giovanni de Gaetano, Maria Benedetta Donati. Scientific secretariat: Marialaura Bonaccio, Americo Bonanni, Chiara Cerletti, Simona Costanzo, Amalia De Curtis, Augusto Di Castelnuovo, Alessandro Gialluisi, Francesco Gianfagna, Mariarosaria Persichillo, Teresa Di Prospero. Safety and ethical committee: Jos Vermylen, Renzo Pegoraro, Antonio Spagnolo. External event adjudicating committee: Deodato Assanelli, Livia Rago. Baseline and follow-up data management: Simona Costanzo, Marco Olivieri, Teresa Panzera. Data analysis: Augusto Di Castelnuovo, Marialaura Bonaccio, Simona Costanzo, Simona Esposito, Alessandro Gialluisi, Francesco Gianfagna, Sabatino Orlandi, Emilia Ruggiero, Alfonsina Tirozzi. Biobank, molecular and genetic laboratory: Amalia De Curtis, Sara Magnacca, Fabrizia Noro, Alfonsina Tirozzi. Recruitment staff: Mariarosaria Persichillo, Francesca Bracone, Teresa Panzera. Communication and press office: Americo Bonanni. Regional institutions: Direzione Generale per la Salute - Regione Molise; Azienda Sanitaria Regionale del Molise; Agenzia Regionale per la Protezione Ambientale del Molise; Molise Dati Spa; Offices of vital statistics of the Molise region. Hospitals: Presidi Ospedalieri ASReM: Ospedale A. Cardarelli, Campobasso; Ospedale F. Veneziale, Isernia; Ospedale San Timoteo, Termoli (CB); Ospedale Ss. Rosario, Venafro (IS); Ospedale Vietri, Larino (CB); Ospedale San Francesco Caracciolo, Agnone (IS); Casa di Cura Villa Maria, Campobasso; Ospedale Gemelli Molise, Campobasso; IRCCS Neuromed, Pozzilli (IS), Italy.
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