慢性心力衰竭患者短期预后预测因素分析OA

Aim To investigate the predictive factors and their value for short-term prognosis in patients with chronic heart failure(CHF).Methods Clinical data of 168 CHF patients were retrospectively analyzed.Patients were divided into a poor prognosis group and a good prognosis group based on whether major adverse cardiovascular events occurred within 6 months after dis-charge.Clinical data were compared between the two groups.Cox regression analysis was used to identify factors influencing poor prognosis.The predictive value of each factor was evaluated by ROC curve.Results The poor prognosis group had higher pro-portions of patients with older age,higher cardiac troponin T(cTnT),higher blood urea nitrogen/albumin ratio(B/A),hypertension,New York Heart Association(NYHA)class Ⅳ,and N-terminal pro-brain natriuretic peptide(NT-proBNP)>1 800 ng/L,as well as lower left ventricular ejection fraction(LVEF)levels,compared with the good prognosis group(P<0.05).Multivariate Cox regression analysis showed that NT-proBNP>1 800 ng/L,NYHA class Ⅲ or Ⅳ,and elevated B/A ratio were risk factors for poor short-term prognosis in CHF patients,while elevated LVEF was a protective factor(P<0.05).The combined model(NT-proBNP,LVEF,B/A ratio,NYHA class)achieved an AUC of 0.839 for predicting poor prognosis,which was higher than that of each individual indicator(P<0.05).Conclusion B/A ratio,NT-proBNP>1 800 ng/L,NYHA class Ⅳ,and LVEF collectively influence the short-term prognosis of CHF patients,and the combined model based on these factors has a high predictive value.