神经肽Y作为电风暴预后的生物标志物。

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-04-01 DOI:10.1016/j.jacep.2024.11.021

Jianjun Tang MD , Chengfeng Liu BSc , Zhuo Wang MD , Tongjian Zhu MD , Min Zhong BSc , Yasai Li BSc , Mingxian Chen MD

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引用次数: 0

摘要

背景：以复发性室性心律失常为特征的电风暴（ES）是一个重大的临床挑战，因此确定可靠的死亡率生物标志物对于风险分层和有针对性的干预至关重要。目的：本研究的目的是探讨神经肽Y （NPY）水平与药物难治性ES患者死亡率之间的关系。方法：进行前瞻性队列研究，纳入95例诊断为ES的患者。患者分为2组：对照组（n = 62）和难治性组（n = 33）。在入组时收集人口统计学和临床数据。住院期间测定血浆NPY水平。采用接受者-工作特征曲线定义NPY阈值，使用约登指数确定ES患者死亡风险增加的最佳截止点。根据NPY阈值将患者分为低NPY组和高NPY组。Kaplan-Meier生存曲线比较采用log-rank检验。采用Cox比例风险模型评估NPY水平与死亡率之间的关系。结果：难治组患者静脉NPY水平明显高于对照组。受体工作特征分析确定NPY阈值为44.4 pg/mL，敏感性为0.91，特异性为0.90。基线NPY水平升高与ES患者死亡风险增加显著相关（95% CI: 0.89-0.99）。生存曲线描绘了高和低NPY水平患者之间的明显差异，突出了NPY水平升高与死亡率增加的关联。结论：NPY可作为ES患者风险分层的潜在生物标志物。

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Neuropeptide Y as a Prognostic Biomarker in Electrical Storm

Background

Electrical storm (ES), characterized by recurrent ventricular arrhythmias, presents a major clinical challenge, so the identification of dependable biomarkers of mortality is essential for risk stratification and targeted intervention.

Objectives

The aim of this study was to investigate the potential utility of neuropeptide Y (NPY) levels in association with mortality in patients experiencing drug-refractory ES.

Methods

A prospective cohort study was conducted, enrolling 95 patients diagnosed with ES. They were divided into 2 groups: a control group (n = 62) and a refractory group (n = 33). Demographic and clinical data were collected at enrollment. Plasma NPY levels were measured in hospitalization. A receiver-operating characteristic curve was used to define an NPY threshold, with Youden’s index applied to identify the optimal cutoff point for heightened mortality risk in patients with ES. According to NPY threshold, patients were divided into a low NPY group and a high NPY group. The log-rank test was used for Kaplan-Meier survival curve comparison between 2 groups. Cox proportional hazards modeling was used to assess the association between NPY level and mortality.

Results

Patients in the refractory group exhibited significantly higher venous NPY levels compared with those in the control group. Receiver-operating characteristic analysis identified an NPY threshold of 44.4 pg/mL with sensitivity of 0.91 and specificity of 0.90. Elevated baseline NPY levels were significantly associated with an increased risk for mortality in patients with ES (95% CI: 0.89-0.99). The survival curves depicted a clear divergence between patients with high and low NPY levels, highlighting the association of elevated NPY level with increased mortality.

Conclusions

NPY emerges as a potential biomarker for risk stratification in patients experiencing ES.

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.