Predictive role of preoperative serum hsTnI,Hcy and BNP in postoperative prognosis of patients undergoing heart valve replacement
Objective To analyze the predictive role of preoperative serum high-sensitivity tropo-nin I(hs-TnI),homocysteine (Hcy) and brain natriuretic peptide (BNP) in patients undergoing heart valve re-placement (CVR).Methods 132 patients who underwent CVR from January 2020 to January 2023 at Zheng-zhou Seventh People's Hospital were selected.Follow-up was performed for one-year post-operation,and the follow-up was analyzed and grouped.The levels of serum hsTnI,Hcy and BNP were compared between the non-adverse event group and the adverse event group.In order to identify the independent risk factors affecting the prognosis of patients undergoing CVR,potential factors such as NYHA grade,LVEF,hsTnI,Hcy and BNP were screened,and univariate analysis was conducted.Subsequently,stepwise multivariate binary logis-tic regression analysis was used to explore the independent influence of these factors on the prognosis of pa-tients.Results Out of the 132 patients who underwent CVR,101 experienced no adverse events at the end of the follow up period (i.e.,the no-adverse-event group) and 31 experienced adverse events (i.e.,the adverse-event group).In the adverse events group,there were 2 cases of prosthetic valve failure,1 case of perivalvular leakage,1 case of prosthetic valve endocarditis,1 case of valve replacement again,6 cases of haemorrhage,3 cases of thromboembolism,15 cases of malignant arrhythmia,and 2 cases of emergence of death,with a total incidence rate of 23.48％ (31/132).Serum hsTnI,Hcy and BNP levels in the adverse-event group were signifi-cantly higher than those in the no-dverse-event group,and the difference was statistically significant (P<0.05).Based on univariate binary logistic regression analysis,the influential factors affecting the prognosis of CVR patients (P<0.05) were NYHA classification,LVEF,hsTnI,Hcy,and BNP.Multifactorial binary logistic re-gression analysis,using the presence or absence of adverse events as the dependent variable (0=no adverse events,1=adverse events),revealed that NYHA class Ⅲ～Ⅳ,LVEF<45％,and elevated levels of serum hsTnI,Hcy,and BNP were independent risk factors affecting the occurrence of postoperative adverse events in patients with CVR (P<0.05).Conclusion Serum hsTnI,Hcy and BNP tests play a crucial role in the post-operative prognosis of patients undergoing CVR.Elevated levels of these biomarkers may indicate a higher risk of adverse events.Therefore,it is important to enhance monitoring and assessment of serum levels of hsTnI,Hcy and BNP in the clinic.This will help in detecting potential risk factors promptly,ultimately improving the prognosis of CVR surgery.
万方数据
维普
