血清FT3水平对冠心病患者PCI术后临床结局的预测价值
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(新疆医科大学第一附属医院心血管病中心高血压科,新疆乌鲁木齐市 830011)

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闫拓,硕士研究生,研究方向为心血管疾病的基础与临床,E-mail:yternxyt@163.com。

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“天山英才”科技创新领军人才项目(2022TSYCLJ0029)


The predictive value of serum FT3 level on clinical outcomes after PCI in patients with coronary heart disease
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Hypertension Department, Cardiovascular Disease Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China)

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    目的]探讨血清游离三碘甲状腺原氨酸(FT3)水平对冠心病患者经皮冠状动脉介入治疗(PCI)术后长期预后的预测价值。 [方法]所有研究对象均来自一项前瞻性队列研究(PRACTICE研究),该研究选取新疆医科大学第一附属医院自2016年12月—2021年10月收治的15 250例冠心病PCI术后患者作为研究对象,收集临床资料、FT3及肌酐等相关指标,所有研究对象均接受定期随访,首要随访终点为全因死亡和心源性死亡,次要终点为主要不良心血管事件(MACE)和主要不良心脑血管事件(MACCE)。按照纳入排除标准,最终有3 109名患者纳入本次研究。根据FT3基线值将患者分为FT3正常组(FT3:3.65~6.8 pmol/L,1 446例)和低FT3组(FT3<3.65 pmol/L,1 663例)。生存分析采用Kaplan-Meier分析,生存率比较采用Log-rank检验。应用多因素Cox回归分析评估两组患者随访结局的危险因素。 [结果]与FT3正常组相比,低FT3组全因死亡、心源性死亡均明显增加(P<0.05)。Kaplan-Meier分析结果显示,低FT3组全因死亡和心源性死亡的累计风险增加(均P<0.05)。多因素Cox回归分析显示,与FT3正常组相比,低FT3组全因死亡风险增加了1.639倍(HR=2.639,95%CI:1.385~5.348,P=0.007),而心源性死亡在多因素调整后未发现统计学差异(P=0.125)。 [结论]血清FT3水平降低对冠心病患者PCI术后全因死亡具有重要的预测价值。

    Abstract:

    Aim To explore the predictive value of serum free triiodothyronine (FT3) on the long-term prognosis of patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods All the subjects were from a prospective cohort study (PRACTICE study). In this study, 15 250 patients with coronary heart disease after PCI in the First Affiliated Hospital of Xinjiang Medical University were selected, and the clinical data, FT3 and creatinine were collected. All the subjects were followed up regularly, and the primary follow-up endpoints were all-cause mortality and cardiogenic mortality, the secondary endpoints were major adverse cardiovascular events (MACE) and major adverse cardiovascular and cerebrovascular events (MACCE). According to the admission criteria, 3 109 patients were finally included in this study. According to the baseline value of FT3, patients were divided into normal FT3 group (FT3:3.65~6.8 pmol/L, 1 446 cases) and low FT3 group (FT3<3.65 pmol/L, 1 663 cases). Kaplan-Meier analysis was used for survival analysis, and Log-rank test was used for survival comparison. Multivariate Cox regression analysis was used to evaluate the risk factors of the follow-up results of the two groups. Results Compared with the normal FT3 group, all-cause mortality and cardiogenic mortality in the low FT3 group increased significantly (P<0.05). Kaplan-Meier analysis showed that the cumulative risk of all-cause mortality and cardiogenic mortality increased in the low FT3 group (P<0.05).Multivariate Cox regression analysis indicated that the risk of all-cause mortality increased by 1.639 folds in the low FT3 group (HR=2.9,5%CI:1.385~5.348, P=0.007), while no statistical difference was found in cardiogenic mortality after adjusting for multiple factors (P=0.125). Conclusion The decrease in serum FT3 levels has important predictive value for all-cause mortality after PCI in patients with coronary heart disease.

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闫拓,单春方,吴婷婷,姜智慧,郑颖颖,谢翔.血清FT3水平对冠心病患者PCI术后临床结局的预测价值[J].中国动脉硬化杂志,2025,33(1):45~50.

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  • 收稿日期:2024-03-08
  • 最后修改日期:2024-10-16
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  • 在线发布日期: 2025-01-26