| Objective: To explore the risk factors of heart failure and the prognostic guidance of serum s ST2 in the progression of heart failure.Methods: A total of 154 patients with heart failure who were treated in our hospital from January 2017 to March 2018 were selected for retrospective analysis.Inclusion criteria: All patients met the diagnostic criteria for heart failure;the selected patients’ cardiac function was between NYHA cardiac function classification 1-3;the patient’s consciousness was clear and can be expressed in words or language;all follow-up family members signed informed consent book.Exclusion criteria: patients who are unable to communicate effectively due to hearing or educational level;combined with hematological diseases;combined with underlying diseases such as congenital heart disease,severe liver disease,and kidney disease;combined with psychotic diseases;previous history of active gastrointestinal bleeding Patients;patients with poor compliance or withdrawal from the study who were unable to complete the study;Preoperative and intraoperative variables in this study were consulted from previous reports and they included age,gender,height,weight,alcohol and tobacco hobbies,Living environment,coronary heart disease,followed up for six months,statistical adverse events occurred.All variables with a P-value less than 0.05 were entered into the multivariate logistic regression analysis to determine the independent risk factors of heart failure.Using cardiac ultrasound machine measured patients’ LVEDD,LVMI,LVEF and other indicators.According to the different levels of serum s ST2,divided into high-level group and low-level group,,and then analysis the influence of prognostic indicators in patients with heart failure of different levels of serum s ST2 pairs and the correlation between serum s ST2 levels and heart failure related indicators.The predictive value of serum s ST2 for heart failure was undertaken using the receiver operating characteristic(ROC)curve,and the results were quantitatively described by the area under the curve.All reported P-values were 2-sided,and P-values less than 0.05 were considered significant.Results: Single factor analysis results showed that patients with age ≥ 70 years(P<0.05),body mass index≥ 25(P<0.05),disease duration ≥ 10 years(P<0.05),alcohol and tobacco hobbies(P<0.05),coronary heart disease(P<0.05)and haze(P<0.05)were risk factors for heart failure in patients.Multiple-factor analysis showed that patients with age ≥ 70 years(OR=4.057,95%CI:1.291-11.576,P<0.05),body mass index≥25(OR=2.068,95% CI:0.611-6.059,P<0.05),disease duration≥ 10years(OR=7.053,95% CI:1.435-31.192,P<0.05),and alcohol and tobacco hobbies(OR=6.086,95% CI:1.015-5.942,P<0.05)are independent risk factors for heart failure;Compared with low level group,patients with heart failure in high serum s ST2 group,the incidence of adverse cardiovascular events was significantly higher,and the LVEDD and LVMI levels were significantly higher than the low level group.The serum s ST2 levels in patients with heart failure were positive with LVEDD and LVMI(r=0.256,r=0.397),and negatively correlated with LVEF(r=-0.418)(P<0.05).The area under the ROC curve of s ST2 predicting cardiovascular events was 0.787,95% CI:0.710-0.865.When the sum of sensitivity and specificity was maximum,51.53μg/L was the optimal cut-off value,and the sensitivity and specificity was 76.3% and 63% at this time,respectively.Conclusion:(1)Heart failure is associated with a number of factors,and age≥ 70 years,body mass index≥ 25,disease duration ≥ 10 years,and alcohol and tobacco hobbies are independent risk factors of heart failure.(2)Serum s ST2 can be used as an important reference for assessing the progression of heart failure,and has important clinical predictive value;(3)This study is a retrospective observational study;thus,the above conclusions are needed to verify in future larger scale randomized clinical controlled trials. |
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