Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients

WANG Yu; WU Na; YANG Lanqing; YUAN Zhiquan; LI Chengying; WU Long; ZENG Yuhong; YANG Lei; CHEN Yanxiu; CHEN Xinghua; ZHONG Li; YANG Jingyuan; LI Yafei

doi:10.16016/j.2097-0927.202409099

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Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients

Clinical Medicine | 更新时间：2025-01-23

- Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients
- Journal of Army Medical University Vol. 47, Issue 2, Pages: 151-160(2025)
- 作者机构：
  
  1.贵州医科大学公共卫生与健康学院，环境污染与疾病监控教育部重点实验室，；陆军军医大学（第三军医大学），贵州贵阳
  2.军事预防医学系军队流行病学教研室
  3.第一附属医院心内科，重庆
  4.重庆医科大学附属第三医院心血管疾病中心，重庆
- 作者简介：
  
  YANG Jingyuan， E-mail： yangjingyuan@gmc.edu.cn
  LI Yafei， E-mail： liyafei2008@hotmail.com；
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(82073649)
- DOI：10.16016/j.2097-0927.202409099
  CLC： R181.23;R446.112;R541.75
- Published：30 January 2025，
  
  Received：14 September 2024，
  
  Revised：21 October 2024，
- 稿件说明：
移动端阅览
WANG YU, WU NA, YANG LANQING, et al. Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients. [J]. Journal of army medical university, 2025, 47(2): 151-160.
DOI：

WANG YU, WU NA, YANG LANQING, et al. Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients. [J]. Journal of army medical university, 2025, 47(2): 151-160. DOI： 10.16016/j.2097-0927.202409099.

摘要

目的

探索外周血SNORD55相对表达水平与房颤患者全因死亡及卒中结局的关联，并评估其对房颤患者预后的预测价值。

方法

共纳入2014年1月至2017年12月在陆军军医大学第一附属医院心内科住院的133名非瓣膜性房颤患者。收集基线信息，检测血浆SNORD55相对表达水平。运用Cox比例风险模型探索外周血SNORD55相对表达水平与房颤患者全因死亡和卒中结局的关联。分析在CHA

-VASc评分基础上添加SNORD55相对表达水平后，与原评分相比对房颤患者全因死亡和卒中结局预测能力是否改善。应用受试者工作特征曲线下面积（area under curve， AUC）评估区分度，计算净重新分类指数（net reclassification index， NRI）、综合判别改善指数（integrated discrimination improvement index， IDI）评估重分类能力的改善情况。通过决策曲线分析（decision curve analysis， DCA）比较临床净收益的变化情况。

结果

多因素Cox回归结果表明，外周血中高表达的SNORD55是房颤患者全因死亡和卒中结局的独立危险因素。针对全因死亡和卒中结局，添加SNORD55相对表达水平后的CHA

-VASc评分相较原评分有更高的AUC［分别为0.67（95％

：0.53～0.81）和0.80（95％

：0.67～0.93），

0.05］。加入SNORD55相对表达水平后的CHA

-VASc评分，在全因死亡和卒中结局中，其NRI和IDI都有一定的增加［NRI分别为31.9（95％

：2.8～47.5）、54.3（95％

：10.6～61.9），IDI分别为7.9（95％

：0.5～14.8）、16.1（95％

：2.4～27.0），

0.05］。DCA结果显示，添加SNORD55相对表达水平后的CHA

-VASc评分和国外ABC评分，在全因死亡和卒中结局中都较原评分有更高的临床净收益。

结论

外周血SNORD55水平是房颤患者全因死亡和卒中结局的独立危险因素，且对房颤患者全因死亡和卒中结局有较好的预测能力。

Abstract

Objective‍　‍To explore the association between the relative expression level of SNORD55 in peripheral blood and the outcomes of all-cause mortality and stroke in patients with atrial fibrillation （AF）， and to evaluate the predictive value of SNORD55 for prognosis. Methods‍　‍A total of 133 patients with non-valvular AF admitted in Department of Cardiology of the First Affiliated Hospital of Army Medical University from January 2014 to December 2017 were enrolled in this study. Their baseline information was collected， and the relative expression level of plasma SNORD55 was detected. Cox proportional hazards model was used to explore the association between the relative expression level of SNORD55 in peripheral blood and all-cause mortality as well as stroke in the patients. The predictive performance of CHA

-VASc score for all-cause mortality and stroke was compared with the score combined with the relative expression level of SNORD55 in the AF patients. The area under the receiver operating characteristic curve （AUC） was utilized to evaluate the discrimination， and the net reclassification index （NRI） and comprehensive discriminant improvement index （IDI） were calculated to evaluate the improvement of reclassification ability. Decision curve analysis （DCA） was applied to analyze the change in clinical net benefit. Results‍　‍The results of multivariate Cox regression showed that high expression of SNORD55 in peripheral blood was an independent risk factor for all-cause mortality and stroke in the AF patients. In predicting the outcomes of all-cause mortality and stroke， the addition of relative expression SNORD55 level with the CHA

-VASc score obtained higher AUC value ［0.80 （95%

： 0.67~0.93）

0.67 （95%

： 0.53~0.81），

0.05］. In predicting the outcome of all-cause death and stroke， combination of the relative expression level of SNORD55 with CHA2DS2-VASc score increased both

NRI ［54.3 （95%

： 10.6~61.9）

31.9 （95%

： 2.8~47.5），

0.05］ and IDI ［16.1 （95%

： 2.4~27.0）

7.9 （95%

： 0.5~14.8），

0.05］. The results of DCA showed that our combination of CHA

-VASc score relative expression level of SNORD55 had higher clinical net benefits than the foreign ABC score in the prediction of the outcomes. Conclusion‍　‍Peripheral blood SNORD55 level is an independent risk factor for all-cause mortality and stroke in AF patients， and has good predictive performance for all-cause mortality and stroke in the patients.

关键词

心房颤动SNORD55风险评估预后

Keywords

atrial fibrillationSNORD55risk assessmentprognosis

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