Prognostic Significance of Serum Cholinesterase Level in Patients With Acute Decompensated Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT-HFpEF Registry

被引：47

作者：

Seo, Masahiro ^{[1
]}

Yamada, Takahisa ^{[1
]}

Tamaki, Shunsuke ^{[1
]}

Hikoso, Shungo ^{[2
]}

Yasumura, Yoshio ^{[3
]}

Higuchi, Yoshiharu ^{[4
]}

Nakagawa, Yusuke ^{[5
]}

Uematsu, Masaaki ^{[6
]}

Abe, Haruhiko ^{[6
]}

Fuji, Hisakazu ^{[7
]}

Mano, Toshiaki ^{[8
]}

Nakatani, Daisaku ^{[2
]}

Fukunami, Masatake ^{[1
]}

Sakata, Yasushi ^{[2
]}

机构：

[1] Osaka Gen Med Ctr, Div Cardiol, Osaka, Japan

[2] Osaka Univ, Grad Sch Med, Div Cardiovasc Med, Osaka, Japan

[3] Amagasaki Chuo Hosp, Dept Cardiol, Amagasaki, Hyogo, Japan

[4] Osaka Police Hosp, Div Cardiol, Osaka, Japan

[5] Kawanishi City Hosp, Div Cardiol, Kawanishi, Japan

[6] Natl Hosp Org Osaka Natl Hosp, Cardiovasc Div, Osaka, Japan

[7] Kobe Ekisaikai Hosp, Cardiovasc Div, Kobe, Hyogo, Japan

[8] Kansai Rosai Hosp, Div Cardiol, Amagasaki, Hyogo, Japan

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2020年 / 9卷 / 01期

关键词：

cholinesterase; heart failure; malnutrition; nutritional indices; risk stratification; NUTRITIONAL RISK INDEX; GHRELIN; BUTYRYLCHOLINESTERASE; MORTALITY; SURVIVAL; DIAGNOSIS; CACHEXIA; IMPACT;

D O I：

10.1161/JAHA.119.014100

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Malnutrition is one of the most important comorbidities in patients with heart failure with preserved ejection fraction. We recently reported the prognostic significance of serum cholinesterase level and superior predictive power of cholinesterase level to other objective nutritional indices such as the controlling nutritional status score, prognostic nutritional index, and geriatric nutritional risk index in patients with acute decompensated heart failure. The aim of this study was to clarify the prognostic role of cholinesterase in patients with heart failure with preserved ejection fraction/acute decompensated heart failure and investigate incremental cholinesterase value. Methods and Results We prospectively studied 274 consecutive patients from the PURSUIT-HFpEF (Prospective Multicenter Observational Study of Patients with Heart Failure With Preserved Ejection Fraction) study. During a follow-up period of 1.2 +/- 0.6 years, 56 patients reached the composite end points (cardiovascular death and readmission for worsening heart failure). In the multivariable Cox analysis, cholinesterase level was significantly associated with the composite end points after adjustment for major confounders. A Kaplan-Meier analysis revealed that patients with low cholinesterase levels (stratified by tertile) had significantly greater risk of reaching the composite end points than those with middle or high cholinesterase levels (P=0.0025). Cholinesterase level showed the best C-statistics (0.703) for prediction of the composite end points among the objective nutritional indices. C-statistics of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score for prediction of the composite end points were improved when cholinesterase level was added (C-statistics, from 0.601 to 0.705; P=0.0408). Conclusions Cholinesterase was a useful prognostic marker for prediction of adverse outcome in patients with heart failure with preserved ejection fraction/acute decompensated heart failure.

引用

页数：15

共 41 条

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