Rita Ferreira, Sofia Lazaro Mendes, Francisco Soares, Francisco Gonçalves, Pedro Monteiro, Silvia Monteiro, Mariano Pêgo
{"title":"血红蛋白变异是急性冠状动脉综合征死亡率的线性预测因子吗?","authors":"Rita Ferreira, Sofia Lazaro Mendes, Francisco Soares, Francisco Gonçalves, Pedro Monteiro, Silvia Monteiro, Mariano Pêgo","doi":"10.1016/j.ctrsc.2016.05.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><p>Coronary artery disease is a common health problem. The aim of this study was to evaluate the prognosis impact on mortality of the variation of hemoglobin (Hb) levels during hospitalization time.</p></div><div><h3>Methods</h3><p>The retrospective observational study included 2640 patients admitted for acute coronary syndrome in a single coronary care unit from May 2004 until June 2013.</p><p>The primary endpoint was all cause of death at 1<!--> <!-->year of follow up time, and secondary endpoint was all cause of death at 2<!--> <!-->years of the follow up time.</p></div><div><h3>Results</h3><p>Four groups were created according to the quartiles of Hb variation (admission Hb minus lowest Hb value) during the hospitalization time: group 1: ≥<!--> <!-->2.1<!--> <!-->g/dL with 627 patients; group 2: ><!--> <!-->1.1 and <<!--> <!-->2.1<!--> <!-->g/dL with 666 patients; group 3: ><!--> <!-->0.3 and ≤<!--> <!-->1.1<!--> <!-->g/dL with 686 patients and group 4: ≤<!--> <!-->0.3<!--> <!-->g/dL with 661 patients.</p><p>A total of 84 patients (3.2%) died during the first year of the follow up. More patients died in group 1 and 4 (6.4% vs 3.7% vs 3.7% vs 6.8%, Log-Rank<!--> <!-->=<!--> <!-->0.023). At 2<!--> <!-->years of follow-up, the results were similar, with higher mortality in group 4 (7.3% vs 4.3% vs 4.6% vs 9.2%, Log-Rank<!--> <!-->=<!--> <!-->0.003).</p><p>Multivariate analysis showed that Hb variation ><!--> <!-->1.1 was an independent predictor of mortality (hazard ration<!--> <!-->=<!--> <!-->0309 95% confidence interval, 0.136–0.702; <em>P</em> <!-->=<!--> <!-->0.005).</p></div><div><h3>Conclusion</h3><p>The patients with the lower baseline hemoglobin and the variability of Hb highest than 1.1<!--> <!-->mg/dL had the worse prognosis with high mortality rate during the follow up time.</p></div>","PeriodicalId":91232,"journal":{"name":"Clinical trials and regulatory science in cardiology","volume":"19 ","pages":"Pages 9-12"},"PeriodicalIF":0.0000,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ctrsc.2016.05.005","citationCount":"3","resultStr":"{\"title\":\"Is hemoglobin variation a linear predictor of mortality in acute coronary syndrome?\",\"authors\":\"Rita Ferreira, Sofia Lazaro Mendes, Francisco Soares, Francisco Gonçalves, Pedro Monteiro, Silvia Monteiro, Mariano Pêgo\",\"doi\":\"10.1016/j.ctrsc.2016.05.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><p>Coronary artery disease is a common health problem. The aim of this study was to evaluate the prognosis impact on mortality of the variation of hemoglobin (Hb) levels during hospitalization time.</p></div><div><h3>Methods</h3><p>The retrospective observational study included 2640 patients admitted for acute coronary syndrome in a single coronary care unit from May 2004 until June 2013.</p><p>The primary endpoint was all cause of death at 1<!--> <!-->year of follow up time, and secondary endpoint was all cause of death at 2<!--> <!-->years of the follow up time.</p></div><div><h3>Results</h3><p>Four groups were created according to the quartiles of Hb variation (admission Hb minus lowest Hb value) during the hospitalization time: group 1: ≥<!--> <!-->2.1<!--> <!-->g/dL with 627 patients; group 2: ><!--> <!-->1.1 and <<!--> <!-->2.1<!--> <!-->g/dL with 666 patients; group 3: ><!--> <!-->0.3 and ≤<!--> <!-->1.1<!--> <!-->g/dL with 686 patients and group 4: ≤<!--> <!-->0.3<!--> <!-->g/dL with 661 patients.</p><p>A total of 84 patients (3.2%) died during the first year of the follow up. More patients died in group 1 and 4 (6.4% vs 3.7% vs 3.7% vs 6.8%, Log-Rank<!--> <!-->=<!--> <!-->0.023). At 2<!--> <!-->years of follow-up, the results were similar, with higher mortality in group 4 (7.3% vs 4.3% vs 4.6% vs 9.2%, Log-Rank<!--> <!-->=<!--> <!-->0.003).</p><p>Multivariate analysis showed that Hb variation ><!--> <!-->1.1 was an independent predictor of mortality (hazard ration<!--> <!-->=<!--> <!-->0309 95% confidence interval, 0.136–0.702; <em>P</em> <!-->=<!--> <!-->0.005).</p></div><div><h3>Conclusion</h3><p>The patients with the lower baseline hemoglobin and the variability of Hb highest than 1.1<!--> <!-->mg/dL had the worse prognosis with high mortality rate during the follow up time.</p></div>\",\"PeriodicalId\":91232,\"journal\":{\"name\":\"Clinical trials and regulatory science in cardiology\",\"volume\":\"19 \",\"pages\":\"Pages 9-12\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ctrsc.2016.05.005\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical trials and regulatory science in cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405587516300154\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical trials and regulatory science in cardiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405587516300154","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
摘要
背景与目的冠状动脉疾病是一种常见的健康问题。本研究的目的是评估住院期间血红蛋白(Hb)水平变化对预后和死亡率的影响。方法回顾性观察性研究纳入2004年5月至2013年6月在同一冠状动脉护理病房收治的2640例急性冠状动脉综合征患者。主要终点为随访1年的所有死亡原因，次要终点为随访2年的所有死亡原因。结果根据住院期间Hb变化(入院Hb减去最低Hb值)的四分位数分为四组:第一组:≥2.1 g/dL，共627例;第二组:>1.1和<2.1 g/dL 666例;第三组:>0.3和≤1.1 g/dL 686例，第4组≤0.3 g/dL 661例。在随访的第一年，共有84名患者(3.2%)死亡。1组和4组患者死亡较多(6.4% vs 3.7% vs 3.7% vs 6.8%， Log-Rank = 0.023)。在2年的随访中，结果相似，第4组的死亡率更高(7.3% vs 4.3% vs 4.6% vs 9.2%， Log-Rank = 0.003)。多因素分析显示Hb变异>1.1是死亡率的独立预测因子(危险比= 0309,95%可信区间，0.136-0.702;p = 0.005)。结论基线血红蛋白较低、Hb变异性高于1.1 mg/dL的患者预后较差，随访期间死亡率较高。
Is hemoglobin variation a linear predictor of mortality in acute coronary syndrome?
Background and objectives
Coronary artery disease is a common health problem. The aim of this study was to evaluate the prognosis impact on mortality of the variation of hemoglobin (Hb) levels during hospitalization time.
Methods
The retrospective observational study included 2640 patients admitted for acute coronary syndrome in a single coronary care unit from May 2004 until June 2013.
The primary endpoint was all cause of death at 1 year of follow up time, and secondary endpoint was all cause of death at 2 years of the follow up time.
Results
Four groups were created according to the quartiles of Hb variation (admission Hb minus lowest Hb value) during the hospitalization time: group 1: ≥ 2.1 g/dL with 627 patients; group 2: > 1.1 and < 2.1 g/dL with 666 patients; group 3: > 0.3 and ≤ 1.1 g/dL with 686 patients and group 4: ≤ 0.3 g/dL with 661 patients.
A total of 84 patients (3.2%) died during the first year of the follow up. More patients died in group 1 and 4 (6.4% vs 3.7% vs 3.7% vs 6.8%, Log-Rank = 0.023). At 2 years of follow-up, the results were similar, with higher mortality in group 4 (7.3% vs 4.3% vs 4.6% vs 9.2%, Log-Rank = 0.003).
Multivariate analysis showed that Hb variation > 1.1 was an independent predictor of mortality (hazard ration = 0309 95% confidence interval, 0.136–0.702; P = 0.005).
Conclusion
The patients with the lower baseline hemoglobin and the variability of Hb highest than 1.1 mg/dL had the worse prognosis with high mortality rate during the follow up time.
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