AIM To study the value of endoplasmic reticulum stress markers in predicting multiple organ failure (MOF) after senile heart failure.
METHODS A total of 126 elderly patients with heart failure admitted to our hospital from March 2019 to March 2021 were selected as study subjects. They were divided into MOF group (21 cases) and non-MOF group (105 cases) according to the occurrence of MOF within thirty days after admission. Clinical data of all patients were collected, including age, gender, BMI, NYHA classification and comorbidities (hypertension, coronary heart disease, diabetes, chronic renal failure, chronic obstructive pulmonary disease, pneumonia). The levels of hemoglobin (Hb), troponin I (TnI), N-terminal pro-B type natriuretic peptide (NT-proBNP) and glucose regulatory protein 78 (GRP78) were compared between the two groups. The risk factors of MOF after senile heart failure were analyzed by non-conditional Logistic regression, the value of GRP78 and NT-proBNP in predicting MOF after senile heart failure was analyzed by ROC curve, and the value of GRP78 combined with NT-proBNP in predicting MOF after senile heart failure was analyzed by consistency analysis.
RESULTS Compared with non MOF group, MOF group had a higher proportion of patients aged ≥ 70 years (P<0.01), complicated with chronic renal failure (P<0.05) and pneumonia (P<0.05); The levels of GRP78 (P<0.05) and NT proBNP (P<0.01) were higher in MOF group; Logistic regression analysis showed that age ≥ 70 years old, chronic renal failure, pneumonia, GRP78 level < 393.609 ng/ml and NT proBNP level ≥ 3879.394 pg/ml were the risk factors of MOF after senile heart failure; ROC analysis showed that GRP78 ≥ 393.609 ng/ml and NT proBNP ≥ 3879.394 pg/ml were the best cutoff values for MOF after senile heart failure (P<0.01). The area under the curve of GRP78 combined with NT proBNP was 0.982, the specificity was 0.933, which was higher than that of single detection, and the sensitivity was 0.857, which was the same as that of NT proBNP but higher than that of GRP78. Logistic regression analysis showed that over 70 years of age, combined with chronic renal failure, pneumonia, GRP78 level <393.609 ng/mL and NT-proBNP level above 3879.394 pg/mL were risk factors for MOF after senile heart failure.
CONCLUSION Among endoplasmic reticulum stress markers, GRP78 is of high value in predicting MOF after senile heart failure. The combined prediction of GRP78 and NT proBNP is helpful to improve the sensitivity and specificity of prediction.
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