血尿素氮水平对急性冠状动脉综合征患者PCI术后MACE的预测价值

doi:10.16352/j.issn.1001-6325.2024.05.0606

基础医学与临床 ›› 2024, Vol. 44 ›› Issue (5): 606-612.doi: 10.16352/j.issn.1001-6325.2024.05.0606

血尿素氮水平对急性冠状动脉综合征患者PCI术后MACE的预测价值

高晓倩^1,2, 于华惠^1,2, 刘圣³, 焦晓璐^1,2, 吕倩雯^1,2, 张铭³, 秦彦文^1,2*

1.首都医科大学附属北京安贞医院/北京市心肺血管疾病研究所,北京 100029;
首都医科大学附属北京安贞医院 2.心血管重塑相关疾病教育部重点实验室; 3.首都医科大学附属北京安贞医院心内科,北京 100029

收稿日期:2024-02-15 修回日期:2024-03-19 出版日期:2024-05-05 发布日期:2024-04-23
通讯作者: ^*qinyanwen@vip.126.com
基金资助:
国家重点研发计划(2021YFC2500600,2021YFC2500603);北京市医学科研院所公益性发展和改革试点项目(JYY2021-7)

Value of blood urea nitrogen level in prediction of MACE after PCI in patients with acute coronary syndrome

GAO Xiaoqian^1,2, YU Huahui^1,2, LIU Sheng³, JIAO Xiaolu^1,2, LYU Qianwen^1,2, ZHANG Ming³, QIN Yanwen^1,2*

1. Beijing Anzhen Hospital, Capital Medical University/Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing 100029;
2. Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; 3. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

Received:2024-02-15 Revised:2024-03-19 Online:2024-05-05 Published:2024-04-23
Contact: ^*qinyanwen@vip.126.com

摘要/Abstract

摘要： 目的探讨血尿素氮(BUN)水平与急性冠状动脉综合征(ACS)患者接受经皮冠状动脉介入(PCI)治疗后发生主要心血管不良事件(MACE)的关联及预测价值。方法选取2017年4月至2017年11月在首都医科大学附属北京安贞医院心内科首次接受PCI手术的ACS患者。经过 36 个月的随访,本研究共纳入了487例患者,包括114例发生MACE的受试者和373例没有发生MACE的受试者。利用Cox比例风险回归模型分析 BUN与ACS患者PCI术后发生MACE的风险比及其95% CI,并使用受试者工作特征(ROC)曲线下面积(AUC)变化来评估BUN的预测效果。结果调整混杂因素后,Cox比例风险回归分析显示,与低水平BUN组相比,高水平BUN组发生MACE风险增加约4倍(OR=4.722,95% CI 1.716~12.993)。将BUN纳入心血管事件风险的基本预测模型及SCORE模型后,AUC面积显著提高(P＜0.001)。结论血BUN可独立于传统危险因素预测ACS患者PCI术后的MACE风险。

关键词: 急性冠状动脉综合征, 主要不良心血管事件(MACE), 血尿素氮, 经皮冠状动脉介入治疗(PCI)

Abstract: Objective To explore the relationship and predictive function of blood urea nitrogen (BUN) level in association with major adverse cardiovascular event(MACE) subsequent to percutaneous coronary intervention(PCI) among patients diagnosed with acute coronary syndrome (ACS). Methods Between April 2017 and November 2017, ACS patients undergoing their initial PCI at the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University were recruited. Following a 36-month follow-up period, 487 patients were included as 114 subjects experiencing MACE and 373 subjects without MACE. The Cox proportional hazards regression model was utilized to assess the risk ratio of MACE and its 95% confidence interval (CI) concerning BUN levels and ACS post-PCI. Additionally, the area under the receiver operating characteristic (ROC) curve (AUC) was applied to assess the predictive effect of BUN. Results After adjusting for confounding variables, Cox proportional hazards regression analysis revealed that the risk of MACE was approximately four times higher in the high BUN level group compared to the low BUN level group (OR=4.722,95% CI 1.716-12.993). Upon inclusion of BUN in both the basic prediction model and SCORE model for cardiovascular event risk, there was a significant increase in the AUC area (P＜ 0.001). Conclusions BUN levels can independently predict the risk of MACE following PCI in ACS patients, irrespective of traditional risk factors.

Key words: acute coronary syndrome, major adverse cardiovascular event(MACE), blood urea nitrogen, percutaneous coronary intervention(PCI)

中图分类号:

R541.4

高晓倩, 于华惠, 刘圣, 焦晓璐, 吕倩雯, 张铭, 秦彦文. 血尿素氮水平对急性冠状动脉综合征患者PCI术后MACE的预测价值[J]. 基础医学与临床, 2024, 44(5): 606-612.

GAO Xiaoqian, YU Huahui, LIU Sheng, JIAO Xiaolu, LYU Qianwen, ZHANG Ming, QIN Yanwen. Value of blood urea nitrogen level in prediction of MACE after PCI in patients with acute coronary syndrome[J]. Basic & Clinical Medicine, 2024, 44(5): 606-612.

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血尿素氮水平对急性冠状动脉综合征患者PCI术后MACE的预测价值

Value of blood urea nitrogen level in prediction of MACE after PCI in patients with acute coronary syndrome

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