Comparison of the value of serum FT3, cTnI and BNP in risk stratification and prognosis prediction to elderly patients with acute heart failure
LIU Yu1 WANG Sudan2 LUO Yuanyuan3 WU Sihui3
1.The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510410, China;
2.Department of Oncology, Shaoyang Hosiptal of Traditional Chinese Medicine, Hunan Province, Shaoyang 422001, China;
3.Department of Critical Care Medicine, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510410, China
Abstract：Objective To compare the application value of serum free triiodothyronine (FT3), cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) in risk stratification and prognosis prediction of elderly patients with acute heart failure (AHF). Methods A retrospective study of 232 patients aged 65 and over with AHF in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2018 to March 2020 was performed. Clinical data of the patients were recorded and followed up for 90 days. According to the severity criteria, the patients were divided into critical group (92 cases) and non-critical group (140 cases). The general data of the critical group and the non-critical group were compared. Multivariate logistic regression analysis was used to evaluate the influencing factors of the critical severity of AHF patients, and receiver-operating characteristic curve was drawn to analyze the predictive effectiveness of relevant indicators for the critical severity of AHF patients. According to the survival within 90 days, patients were divided into death group (34 cases) and non-death group (198 cases). Compared with the general data of the death group and the non-death group, Cox regression was used to analyze the influence of related indicators on the all-cause death of AHF patients. Results The levels of FT3 and left ventricular ejection fraction (LVEF) in the critical group were lower than those in the non-critical group. The levels of creatinine, BNP, and cTnI in the critical group were higher than those in the non-critical group, the differences were statistically significant (P ＜ 0.05). The comparison of New York Heart Association (NYHA) cardiac function grading between the two groups showed statistical significance (P ＜ 0.05). Multivariate logistic regression analysis showed that FT3, LVEF and creatinine were the influencing factors for the severity of elderly AHF after adjusting for age, sex and body mass index (BMI) (P ＜ 0.01). The area under the curve (AUC) predicted by FT3 of critical group was 0.719, 95%CI: 0.653-0.786, sensitivity was 83%, specificity was 57%. cTnI predicted the AUC of critical group was 0.601, 95%CI: 0.526-0.675, sensitivity was 72%, specificity was 48%. BNP predicted the AUC of critical group was 0.623, 95%CI: 0.552-0.695, sensitivity was 69%, specificity was 56%. The level of FT3 in the death group was lower than that in the non-death group, and the level of cTnI was higher than that in the non-death group (P ＜ 0.05). Multivariate Cox regression analysis showed that FT3 and cTNI were the influencing factors of 90 d all-cause death in elderly patients with AHF after adjusting for age, sex, BMI, creatinine and NYHA cardiac function (P ＜ 0.01). Conclusion In terms of prognosis and prognosis, FT3, cTnI, and BNP have their own advantages and disadvantages, and FT3 is a better choice for elderly AHF patients with renal insufficiency.
刘誉1 王素丹2 罗苑苑3 吴思慧3. 血清FT3、cTnI、BNP对老年急性心力衰竭患者危险分层和预后预测的应用价值比较[J]. 中国医药导报, 2021, 18(26): 54-59.
LIU Yu1 WANG Sudan2 LUO Yuanyuan3 WU Sihui3. Comparison of the value of serum FT3, cTnI and BNP in risk stratification and prognosis prediction to elderly patients with acute heart failure. 中国医药导报, 2021, 18(26): 54-59.
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