The Relationship Between Serum Clusterin,ADAMTS-13 and the Condition and Prognosis of Elderly Patients with Acute Heart Failure
Objective To investigate the expression of Clusterin and von Willebrand factor cleaving protease (ADAMTS-13)in serum of elderly patients with acute heart failure (AHF )and to evaluate their relationships with prognosis.Methods Eighty elderly patients with AHF who were treated in our hospital from January,2020 to December,2021 were selected for study.According to the severity of the disease,these patients were grouped into the mild AHF group (n=34)and severe AHF group (n=46),while according to whether terminal events occurred within one year,these patients were divided into the non-terminal event group (n=58)and terminal event group (n=22).Another 80 outpatients with physical examination were regarded as the control group.Multivariate logistic regression was applied to analyze the factors affecting the prognosis of elderly AHF;The predictive value of serum Clusterin and ADAMTS-13 levels on the prognosis of elderly AHF was analyzed by the ROC curve.Results The levels of serum creatinine,creatine kinase isoenzyme (CK-MB),brain natriuretic peptide (BNP),N-terminal pro B type natriuretic peptide (NT-proBNP),troponin I (cTnI ),left ventricular end-diastolic diameter (LVEDD)and Clusterin in AHF group were significantly higher than those in the control group (P<0.05);Left ventricular ejection fraction (LVEF)and ADAMTS-13 were significantly lower than those in the control group (P<0.05).Clusterin in severe AHF group was significantly higher than that in the mild AHF group (P<0.05);ADAMTS-13 was significantly lower than that in the mild AHF group (P<0.05).Compared with the non-terminal event group,serum creatinine,CK-MB,BNP,NT-proBNP,cTnI ,LVEDD and Clusterin in the terminal event group were significantly higher (P<0.05);LVEF and ADAMTS-13 were significantly decreased (P<0.05). Multivariate logistic regression analysis showed that serum ADAMTS-13 was a protective factor for the prognosis of elderly AHF (P<0.05),while Clusterin was a risk factor (P<0.05).The AUC of the combination of serum Clusterin and ADAMTS-13 in predicting the prognosis of elderly patients with AHF was 0.980,with a sensitivity of 90.91％,and a specificity of 96.55％,which was superior to the independent prediction of Clusterin or ADAMTS-13 (Zcombination-Clusterin=2.219,Zcombination-ADAMTS-13=2.269,P=0.027,0.023).Conclusion The expression of serum Clusterin is significantly up-regulated,while ADAMTS-13 is significantly down-regulated in elderly patients with AHF.The combined detection of the two markers has a good predictive value for the prognosis of elderly patients with AHF.
万方数据
维普
