钙通道自身抗体预测慢性心力衰竭患者死亡风险的研究

目的目前的研究发现钙通道A身抗体（CC—AAbs）参与r扩张型心肌病（DCM）的发病并起到重要作用，其在缺血性心肌病（ICM）所敛慢性心力衰竭（CHF）中是否具有作用尚不清楚，本研究旨在评价CC—AAbs在ICM导致的CHF患者中的表达水平及作用方法共人选1255例CHF组患者及834例对照组受斌者，酶联免疫法检测CC—AAbs的表达水平，应用Kaplan—Meier曲线及CoxⅫ¨愉验进行组问比较，并分析CC—AAbs表达与1CM病人预后的相关性，确定CC—AAbs是否为ICM患者猝死（SCD）、非猝死性死广（NSCD）和全因死亡的独立预测因子结果完成随访1099例，失访156例（失访率12．4％），发生死亡330例，猝死121例．随访中位数为52月（0．40—92月）CHF患者中CC—AAbs的阳性表达明显高于正常对照（4．64％VS．1．20％，p〈0．001）。Cox回归分析表明阳性CC—AAbs‘jCHF患者的死亡呈明显正相关，CC—AAbs阳性可以预测ICM患者的猝死（HR：2．805，95％CI：1．488—5．288）、菲猝死性死亡（HR：1．887．95％CI：I．081—3．293）及全因死亡（HR：2．219，95％CI：1．461—3，371）。结论我们的研究表明：ICM导致的CHF患曹中CC—AAbs的水平明显增加．并HCC．AAbs的表达与CHF患者的SCD、NSCD及伞因北亡具有明最相关性．是CHF患者SCD、NSCD和伞因北亡的独市预测因子

Calcium Channel Autoantibodies Predict the Risk of Death in Patients with Chronic Heart Failure

Objective Recent studies indicated that calcium channel autoantibodies （CC-AAbs） have been detected in patients with dilated cardiomyopathy （DCM） and may play an important role in autoimmune pathogenesis. It is still unclear the effect of CC-AAbs in patients with chronic heart failure （CHF） from ischemic cardiomyopathy （ICM）. The purpose of this study was to evaluate whether CC-AAbs levels could predict prognosis in CHF patients. Method A total of 1255 ICM patients and 834 control subjects were recruited. CC-AAbs were detected by enzyme-linked immunosorbent assay （ELISA） and the relationship between CC-AAbs and patient prognosis were analyzed. Result During a median follow-up time of 52 months （0.40-92 months）, there were 330 deaths. Of these, sudden cardiac death （SCD） occurred in 121 cases. The presence of CC-AAbs in ICM patients were significantly higher than that of the controls （4.64% vs. 1.20%, both p〈0.001）. Multivariate analysis revealed that positive CC- AAbs was associated with higher mortality in ICM patients and that it predicted SCD （HR 2.805, 95% CI 1.488-5.288） and all-cause death （HR 2.219, 95% CI 1.461-3.371 for ICM）. A significant association between CC-AAbs and non-SCD （NSCD） was also found in ICM patients （HR=1.887, 95% CI 1.081-3.293）. Conclusion Our results demonstrated that presence of CC-AAbs was higher in ICM patients versus controls and corresponds to a higher incidence of all-cause death and SCD. Positive CC-AAbs may serve as an independent predictor for SCD and all-cause death in these patients.