| ObjectiveThe aim of this study is to investigate the factors influencing the prognosis of patients with heart failure with slightly reduced ejection fraction(HFmr EF)using uric acid(UA),erythrocyte pressure(HCT)and serum N-terminal natriuretic peptide precursor(NT-pro BNP),to provide timely identification of and intervention for the risk and a diagnostic clinical benchmark for the preparation and Management of Heart Failure with Slightly Reduced Ejection Fraction(HFmr EF)patients.MethodsPatients who were admitted to the Department of Cardiology of the Second Hospital of Shenyang Medical College and were confirmed to have HFmr EF from January 2021 to November 2022 were selected for the study.A total of 183 cases were included,23 cases were lost to follow-up,and 150 cases were finally included.Sixty-five non-heart failure patients who were in the hospital during the same period were selected as the control group.The recruited HFmr EF patients were followed up for 1 year and the 150 patients were divided into 65 in the MACE group and 85 in the non-MACE group according to whether the HFmr EF patients had a MACE event within 1 year.All of the enrolled subjects had all data collected,including age,sex,height,weight,history of smoking,history of smoking,history of alcohol consumption,history of hypertension,history of diabetes mellitus,red blood cell count,haemoglobin,etc.,erythropoietin,uric acid,serum N-terminal brain natriuretic peptide precursors,blood glucose,total Cholesterol,triglycerides,HDL cholesterol,LDL cholesterol,etc.Cardiac ultrasound was completed,including left ventricular diastolic The statistical analysis was performed using SPSS29.0 software to compare the basic information of the case and control groups.Factors influencing the occurrence of MACE events in patients with HFmr EF were analysed by multifactorial logstic analysis.The subject operating curve(ROC curve)was used to analyse the predictive value of serum UA,HCT and NT-pro BNP individually and in combination for the occurrence of MACE events in patients with HFmr EEF.Results1.A total of 150 patients with HFmr EF participated in this study,with a general mean age of 71.57±12.07 years,62 female patients(41.33%)and 88 male patients(58.67%).The discrepancies in age,height,weight,smoking,alcohol consumption,blood glucose,TC,HDL-C,LDL-C,LVPWD,IVST and LVEF values between the control group and the case group were not considered statistically significant(p>0.05).2.In the group with non-MACE,the levels of LVEDD and NT-pro BNP gradually improved compared to the control group,while the levels of RBC and HCT gradually decreased;the difference was proved to be statistically significant(P<0.05);compared to the group with non MACE,the levels of RBC,HB and HCT gradually decreased,while the levels of UA,TG,LVED and NT-pro BNP gradually increased in the group with MACE,hypertension and diabetes.HCT levels in the group of MACE < non-MACE group < control group,with statistically significant differences between groups(P<0.05);NT-pro BNP in the group of MACE > non-MACE group > control group,with statistically significant differences between groups(P<0.05).3.By binary logistic regression analysis,it was concluded that:UA,HCT and NT-pro BNP were influential factors in the occurrence of M ACE events in HFmr EF patients(UA:OR=8.08,NT-pro BNP:OR:5.643,HC T:OR=0.039,P<0.05).4.The area under the UA curve was 0.783(95% CI:0.709-0.857,P<0.05)with a cut-off value of 418.75,sensitivity 0.736 and specificity 0.731.The area under the HCT curve was 0.889(95% CI:0.836-0.94,P<0.05)with a best cut-off value of 38.15,sensitivity 0.756 and specificity 0.931.The area under the NT-pro BNP curve was 0.800(95% CI:0.730-0.870,P<0.05),with a best cut-off value of 1379,sensitivity of 0.861 and specificity of 0.603.The area under the co-detection curve(AUC)was 0.935(95% CI:0.895,P<0.05).95%CI:0.895-0.976,P<0.05),with a sensitivity of 0.928 and the specificity of0.835.ConclusionsThe three indicators,UA,HCT and NT-pro BNP,are closely related to the prognosis of HFmr EF patients,and the likelihood of MACE events in HFmr EF patients increases with the increase of UA and NT-pro BNP levels and the decrease of HCT levels,suggesting that the three indicators may be risk factors for poor prognosis of HFmr EF patients.At the same time,the association of these three indicators has a predictive value for the prognosis of MACE events in HFmr EF patients. |
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