The Role of the Neutrophil-to-Lymphocyte Ratio in the Development of Heart Failure in Patients with Concomitant Hypertension, Type 2 Diabetes, and Obesity
Sažetak
Cilj.
Arterijska hipertenzija, dijabetes melitus tipa 2 (T2DM) i gojaznost povećavaju kardiovaskularni rizik, uključujući srčanu insuficijenciju (SI). Odnos neutrofila i limfocita (NLR), marker sistemske inflamacije, povezan je sa nepovoljnim kardiovaskularnim ishodima, ali njegova uloga u razvoju SI ostaje nejasna. Ova studija je procenila NLR kao prediktor SI kod ovih pacijenata.
Metode.
U ovu prospektivnu studiju uključeno je ukupno 293 pacijenata sa esencijalnom hipertenzijom, T2DM i gojaznošću. Pacijenti su podeljeni u dve grupe: grupu sa SI (n=85) i grupu bez SI (n=208). NLR je izračunat na osnovu rezultata kompletne krvne slike. Dijagnoza SI je postavljena prema smernicama ESC iz 2023. godine i potvrđena biomarkerima (NT-proBNP) ili ehokardiografijom. Pacijenti su praćeni tokom 24 meseca.
Rezultati.
Pacijenti kod kojih se razvila SI imali su značajno viši NLR (3,39 ± 1,23 vs. 2,66 ± 1,14, p<0,001). Takođe, imali su duže trajanje T2DM (12,75 ± 5,86 vs. 10,25 ± 4,39 godina, p<0,001) i hipertenzije (18,87 ± 8,54 vs. 16,05 ± 7,14 godina, p=0,004). Profil krvnog pritiska tipa "non-dipper" bio je češći u SI grupi (36,5% vs. 20,7%, p=0,005). U multivarijantnoj regresiji, NLR (OR 1,383; 95% CI 1,073–2,222; p=0,037), "non-dipper" profil krvnog pritiska i dužina trajanja bolesti ostali su nezavisni prediktori SI.
Zaključak.
NLR je nezavisno povezan sa razvojem SI kod pacijenata sa hipertenzijom, T2DM i gojaznošću. Može poslužiti kao jednostavan i ekonomičan biomarker za stratifikaciju rizika od SI, omogućavajući ranu intervenciju i poboljšane ishode.
Reference
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