Prognostic factors in heart failure patients with cardiac cachexia
Yu Sato1
Akiomi Yoshihisa2
Yusuke Kimishima1
Tetsuro Yokokawa1
Satoshi Abe1
Takeshi Shimizu1
Tomofumi Misaka2
Shinya Yamada1
Takamasa Sato1
Takashi Kaneshiro1
Masayoshi Oikawa1
Atsushi Kobayashi1
Takayoshi Yamaki1
Hiroyuki Kunii1
Yasuchika Takeishi1
1.Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan2.Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan;Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan
摘要：Objective To clarify whether cardiac cachexia (CC) alters the prognostic impact of other general risk factors in patients with heart failure (HF).Methods This was an observational study.CC was defined as the combination of a body mass index of＜ 20 kg/m2 and at least one of the following biochemical abnormalities:C-reactive protein ＞ 5 mg/L;hemoglobin ＜ 12 g/dL;and/or albumin ＜ 3.2 g/dL.We divided 1608 hospitalized HF patients into a CC group (n =176,10.9％) and a non-CC group (n =1432,89.1％).The primary endpoints were cardiac event and all-cause death.Results The presence of CC showed significant interactions with other risk factors including cancer,estimated glomerular filtration rate (eGFR),and sodium in predicting these endpoints.Multiple Cox proportional analysis revealed that use of(a) blockers [hazard ratio (HR) =1.900,95％ confidence interval (CI):1.045-3.455,P =0.035) and eGFR (HR =0.989,95％ CI:0.980-0.998,P =0.018) were independent predictors of cardiac event in the CC group,while age (HR =1.020,95％ CI:1.002-1.039,P =0.029) and hemoglobin (HR =0.844,95％ CI:0.734-0.970,P =0.017) were independent predictors of all-cause death.The survival classification and regression tree analysis showed the optimal cut-offpoints for cardiac event (eGFR:59.9 mL/min per 1.73 m2) and all-cause death (age,83 years old;hemoglobin,10.1 g/dL) in the CC group.Conclusions In predicting prognosis,CC showed interactions with several risk factors.Renal function,age,and hemoglobin were pivotal markers in HF patients with CC.
机标关键词：
论文发表日期：2020-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 26-34 )
英文信息