| Objective:To evaluate the value of human epididymis protein 4(HE4)in the prognosis of patients with ischemic cardiomyopathy.Method:103 consecutive patients with ischemic cardiomyopathy were admitted to the Department of Cardiology,Hunan Provincial People's Hospital from February 2019 to June 2019.After collecting the patients,about 3ml of blood was collected by centrifugation in the early morning of the second day after admission,and the serum was stored at-80?,and then the level of HE4 serum was detected by chemiluminescent microparticle immunoassay.Recorded the baseline data and HE4 level of the patient,and followed up the patient.Recorded the event at 1 month,3months,6 months,and 12 months after discharged,including cardiovascular death and heart failure re-hospitalization.According to the presence or absence of event,it is divided into two groups.Kaplan-Meier curve and Cox proportional hazard regression model were used for survival analysis.A two-sided P value of less than 0.05 was defined as a statistically significant difference.Results:1.Of the 103 patients,7 were lost to follow-up and a total of 96were enrolled,including 63 males(65.6%),the median age for the 96patients were 71(65-77)years old,and the median follow-up date were263(153-313)days.A total of 45 people had event,of which 12 had cardiovascular deaths,and 33 were hospitalized due to heart failure.2.According to whether event occurred,96 people were divided into two groups.Compared with the group without event,the age of event group was older[75(70-81)years]VS[68(61-73)years],and the heart function classification(NYHA)was more Poor[?/?/?number%]:[8(17.8%)/20(44.4%)/17(37.8%)]VS[19(37.3%)/23(45.1%)/9(17.6%)],N-terminal pro-brain natriuretic peptide(NT-proBNP)level is higher[7084.0(3147.0-15175.5)ng/L]VS[1874.5(937.7-4902.7)ng/L],HE4 level is higher[188.7(113.3-326.8)]pmol/ml VS[92.9(61.5-123.2)]pmol/ml),eGFR is more low(53.72±23.48mL/min/1.73 m~2VS 77.04±25.48mL/min/1.73 m 2),the differences were statistically significant(all P<0.05).3.The correlation analysis results showed that:HE4 and NT-proBNP had a significant positive correlation(r=0.602,P<0.001),age and HE4 had a positive correlation(r=0.571,P<0.001),the Estimated glomerular filtration rate(eGFR)was negatively correlated with HE4(r=-0.697,P<0.001).4.COX multi-factor regression analysis showed that HE4,NT-proBNP,eGFR,NYHA and age were included in the COX multi-factor analysis model.The results showed that HE4(?2:9.602,HR and 95%CI:1.003(1.001-1.005),P=0.002),age(?2:4.557,HR and 95%CI:1.044(1.003-1.085),P=0.033)are independent indicators to predict event.5.Receiver operating characteristic curve analysis showed that when predicting event,the AUC values and the 95%CI was 0.800(0.712-0.888)and 0.766(0.669-0.862)of HE4 and NT-proBNP respectively,and the difference between the two was not statistically significant(P>0.05).6.The risk of event in patients with HE4>100.2pmol/ml was significantly higher than that in patients with HE4?100.2pmol/ml(Log-rank-test:17.662,P<0.001),uncorrected HR and 95%CI:4.826(2.148-10.846),adjusted for age and gender HR and 95%CI:3.372(1.409-8.065).Conclusion:HE4 could predict death and readmission caused by heart failure in patients with ischemic cardiomyopathy. |
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