Osman Uzman, Murat Bastopcu, Mehmet Saygı, Koray Kalenderoğlu, Koray Demir, Kıvanç Keskin, Sait Terzi
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引用次数: 0
摘要
背景：本研究评估经导管主动脉瓣植入术（TAVI）后早期高乳酸血症对后续预后的影响。方法：回顾性分析2012年至2022年在单一三级心脏中心接受选择性经皮TAVI的成年患者。研究中记录了284例患者术后24小时内乳酸水平的峰值。测量的主要结局是30天死亡率。结果：19例患者（6.6%）30天死亡。患者死亡率以高龄（p = 0.022）和术后乳酸水平增高（5.4±5.4 mmol/L vs 1.3±0.6 mmol/L, p = 0.012）为特征。ROC分析显示1.54 mmol/L为死亡率的临界值，特异性为85.7%，敏感性为68.4%。结论：最初24小时乳酸水平似乎在预测植入手术后住院期间存活的可能性方面发挥了重要作用。需要进一步的研究来确定治疗TAVI人群术后早期高乳酸血症的最佳策略。
The relationship of serum lactate level with in-hospital mortality after transcatheter aortic valve implantation.
Background: This study assesses the influence of early hyperlactatemia after the transcatheter aortic valve implantation (TAVI) procedure on subsequent outcomes.
Methods: Adult patients undergoing elective percutaneous TAVI between 2012 and 2022 in a single tertiary cardiac center were retrospectively included. Peak post-procedure lactate level within 24-h was recorded for 284 patients included in the study. The primary outcome measured was 30-day mortality.
Results: 19 patients (6.6%) experienced 30-day mortality. Patients with mortality were characterized by advanced age (p = 0.022) and higher lactate levels after the procedure (5.4 ± 5.4 mmol/L vs 1.3 ± 0.6 mmol/L, p < 0.001). Post-procedure hyperlactatemia was an independent predictor of mortality (OR 3.95, 95% CI 1.35-11.60, p = 0.012). ROC analysis revealed 1.54 mmol/L as a cutoff for mortality with 85.7% specificity and 68.4% sensitivity.
Conclusion: The initial 24-hour lactate levels seem to play a valuable role in predicting the likelihood of surviving during the hospital stay after the implantation procedure. Further investigation is required to ascertain the optimal strategies for managing early post-procedure hyperlactatemia in the TAVI population.
期刊介绍：
Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory.
Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice.
As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications.
Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest.
Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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