Study On The Correlation Between Homocysteine,Cystatin C Combined With NT-proBNP And Prognosis Of Patients With Chronic Heart Failure

ObjectiveTo investigate the prognostic effect of the combination of homocysteine(Hcy),Cysatin C(Cys-C)and N-terminalpro-brainnatriuretic peptide(NT-proBNP)on patients with chronic heart failure(CHF).To provide reference for clinical workers in early evaluation of poor prognosis of chronic heart failure.MethodsSelection of December 2018 to December 2019,The Second Affiliated Hospital of Shenyang Medical College center entry New York Heart Association(NYHA)Heart failure in China cardiac function grade II-IV of the 140 patients with chronic Heart failure,the research of the patient’s clinical basic information collection,including hospitalization time,discharge time,gender,age,height,weight,NYHA classification,past medical history(diabetes,high blood pressure,stroke,atrial fibrillation),life cycle(smoking,drinking),Heart rate,blood pressure and laboratory data after admission:Hcy,Cys-C,NT-proBNP,creatinine,glutamic-pyruvic transaminase,glutamic-oxalacetic transaminase,troponin,myocardial enzyme profile,triglyceride,total cholesterol,fasting blood glucose,etc.All patients received standardized treatment of heart failure,and the main drugs for treatment were:Diuretics,aldosterone receptor antagonists,beta blockers,angiotensin-converting enzyme inhibitors(ACEI),and angiotensin receptor blockers(ARBs)are based on whether or not a major cardiovascular adverse event(MACE)has occurred within 1 year,(death,acute myocardial infarction,cardiogenic shock,and target vessel revascularization)were divided into two groups: group with Mace event and group without Mace event.The patients were followed up for 1 year from the date of discharge.Patients were followed up through outpatient and telephone follow-up until Mace event or the end of the 1-year period.SPSS23 software was used to analyze the data.Continuous variables with normal distribution were represented by mean standard deviation,and inter-group comparisons were performed by independent sample t test.Don’t obey the fall of continuous variables with the median(four digits),said the Mann-Whitney U inspection,classification of count data variable powerusageeffectiveness said,using chi-square test,the statistically significant variables logistics regression analysis,the participants work special curve drawing(ROC curve),to calculate the area under the curve,used to judge the Hcy,Cys-C,NT-proBNP application and combined application of disease together separate ability to predict poor prognosis.P< 0.05 was considered statistically significant.ResultsThe levels of Hcy,Cys-C and NT-proBNP in MACE group were significantly higher than those in non-MACE group,and the difference was statistically significant(P < 0.05).The ROC curve was drawn,and the analysis results showed that the area under the ROC curve for Hcy to predict the risk of MACE within 1 year was 0.824,and the difference was statistically significant(P < 0.001).The area under the ROC curve for Cys-C to predict the risk of MACE within 1 year was 0.748,and the difference was statistically significant(P < 0.001).The area under the ROC curve for NT-proBNP to predict the risk of MACE within 1 year was 0.979,and the difference was statistically significant(P < 0.001).The area under the ROC curve for predicting the risk of MACE within 1 year was 0.980,and the difference was statistically significant(P < 0.001).The sensitivity was 100.00%,and the specificity was 92.39%.Conclusions1.The higher levels of serum Hcy,Cys and NT-proBNP is accompanied the higher probability of occurrence of MACE events in chronic heart failure in patients within 1 year.2.The combined application of serum Hcy,Cys-C and NT-proBNP can better predict the adverse prognosis of chronic heart failure,which has great significance for the diagnosis and treatment of patients with heart failure and the evaluation of adverse prognosis in the future.