The Effect of Plasma Triglyceride-Lowering Therapy on the Evolution of Organ Function in Early Hypertriglyceridemia-Induced Acute Pancreatitis Patients With Worrisome Features (PERFORM Study): Rationale and Design of a Multicenter, Prospective, Observational, Cohort Study

Cao, Longxiang; Zhou, Jing; Chen, Tao; Liu, Man; Lin, Jiyan; Hong, Duck Jin; Yao, Wei; Guo, Fanjia; Zhou, Yun; Jiao, Qinghai; Chen, Yingjie; Ye, Bo; Ke, Lu; Tong, Zhihui; Liu, Yuxiu; Li, Weiqin; Group, Chinese Acute Pancreatitis Clinical Trials

doi:10.3389/fmed.2021.756337

Cited by 11 publications

(16 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[57] Similarly, some other well-conducted studies also reported that higher TG level in AP patients may be linked to adverse prognosis. [58,59] The related pathophysiological mechanism has been mentioned already in our discussion. Blood puri cation, medical treatment with heparin and/or insulin can help in improve triglycerides and further promote the recovery of HTG-AP patients.…”

Section: Discussionmentioning

confidence: 58%

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Luo

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Acute pancreatitis in pregnancy (APIP) with organ failure (OF) is a rare but serious disease. Here, we describe the primary characteristics associated with APIP, and explore potential predictors for early recognition of OF among the patients. Methods: A total of 3154 patients with AP from January 2018 to December 2021 were retrospectively reviewed. After screening, we enrolled 49 patients with APIP and 184 non-pregnant AP patients. Clinical characteristics and blood biochemical information were assessed using IBM SPSS 26.0 software and the rms package in R. Results: The most primary cause of APIP was hypertriglyceridemia (59.2%), while respiratory failure (46.9%) was the main type in all OF patients. Age, hemoglobin (Hb), hematocrit (HCT), aminotransferase (ALT), creatinine (Cr), blood urea nitrogen (BUN), albumin (ALB) and sodium ion (Na+) in the pregnant group were lower than in the non-pregnant group (P<0.05), while body mass index (BMI), triglyceride (TG) and total cholesterol (TC) in the pregnant group were higher (P<0.05). Among the APIP patients, BUN, TG and TC were independent risk factors for predicting OF, (P < 0.05) and they were used to create a nomogram with accurate prediction performance. (AUC=0.941) Conclusions: APIP was highly correlated with hypertriglyceridemia and respiratory failure. Higher BMI was a distinguishing feature of OF-APIP patients. The data indicate that close monitoring of BUN, TG and TC levels is essential for early prevention of OF in APIP patients.

show abstract

Section: Discussionmentioning

confidence: 58%

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Luo

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…However, the benefits of these interventions to the overall outcome of HTG-AP are controversial. More randomized clinical trials would contribute to proposing a generalized and effective treatment modality for HTG-AP in the future [ 26 , 42 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Hyperlipemia pancreatitis onset time affects the association between elevated serum triglyceride levels and disease severity

et al. 2022

View full text Add to dashboard Cite

Background The association of serum triglyceride (TG) levels with the severity of hypertriglyceridaemia-induced acute pancreatitis (HTG-AP) remains controversial. This study aimed to comprehensively assess the TG levels from the initial onset and their predictive value in the disease assessment of HTG-AP. Methods Data collected from January 2018 to July 2021 in one institute were assessed retrospectively. HTG-AP was defined as a TG level > 500 mg/dL in the absence of other common aetiologies of AP. The TG levels within 24 hours (24 h), 48 hours (48 h), 3-4 days (3-4 d), and 5-7 days (5-7 d) after symptom onset and their correlations with disease severity in HTG-AP patients were analysed by cross-sectional and longitudinal studies. Results In the cross-sectional study, 377 HTG-AP patients were included before lipid-lowering intervention: 216 subjects had their first TG levels measured within 24 h after onset, 91 within 48 h, 50 in 3-4 d, and 20 in 5-7 d. TG levels decreased in the 24 h, 48 h and 3-4 d groups (P < 0.001), however, the TG decline in the 5-7 d group had no difference compared with the 3-4 d group. HTG-AP patients with severe or moderately severe disease displayed higher TG levels than those with mild disease in the 24 h and 48 h groups (P < 0.050) but not in the 3-4 d or 5-7 d groups. Furthermore, the TG levels were correlated with the modified computed tomography severity index only in the 24 h and 48 h groups, while an association between serum calcium levels and C-reactive protein levels was only present in the 24 h group. Similarly, the TG levels were related to hospital days and ICU days in the 24 h and/or 48 h groups. In the longitudinal study, 165 patients with complete records of TG levels from 24 h to 5-7 d were enrolled. With supportive care and lipid-lowering treatment after admission, the TG levels declined rapidly (P < 0.001), and the correlations with disease severity weakened or even disappeared from 24 h to 5-7 d. Conclusion TG levels decreased and attenuated the association with disease severity of HTG-AP over the time of onset. The TG levels within the initial 48 h after onset were most useful for the diagnosis and disease assessment of HTG-AP.

show abstract

“…Written informed consent was obtained from each participant or their next of kin. The full protocol of the PERFORM study and the analysis plan of this study were published previously . This report follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for observational studies …”

Section: Methodsmentioning

confidence: 99%

Early Plasmapheresis Among Patients With Hypertriglyceridemia–Associated Acute Pancreatitis

Cao,

Chen,

Liu

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceThe incidence of hypertriglyceridemia–associated acute pancreatitis (HTG-AP) is increasing. Plasmapheresis is theoretically effective in removing triglyceride from plasma, but whether it confers clinical benefits is unclear.ObjectiveTo assess the association between plasmapheresis and the incidence and duration of organ failure among patients with HTG-AP.Design, Setting, and ParticipantsThis is an a priori analysis of data from a multicenter, prospective cohort study with patients enrolled from 28 sites across China. Patients with HTG-AP were admitted within 72 hours from the disease onset. The first patient was enrolled on November 7th, 2020, and the last on November 30th, 2021. The follow-up of the 300th patient was completed on January 30th, 2022. Data were analyzed from April to May 2022.ExposuresReceiving plasmapheresis. The choice of triglyceride-lowering therapies was at the discretion of the treating physicians.Main Outcomes and MeasuresThe primary outcome was organ failure–free days to 14 days of enrollment. Secondary outcomes included other measures for organ failure, intensive care unit (ICU) admission, duration of ICU and hospital stays, incidence of infected pancreatic necrosis, and 60-day mortality. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analyses were used to control potential confounders.ResultsOverall, 267 patients with HTG-AP were enrolled (185 [69.3%] were male; median [IQR] age, 37 [31-43] years), among whom 211 underwent conventional medical treatment and 56 underwent plasmapheresis. PSM created 47 pairs of patients with balanced baseline characteristics. In the matched cohort, no difference was detected concerning organ failure–free days between patients undergoing plasmapheresis or not (median [IQR], 12.0 [8.0-14.0] vs 13.0 [8.0-14.0]; P = .94). Moreover, more patients in the plasmapheresis group required ICU admission (44 [93.6%] vs 24 [51.1%]; P &lt; .001). The IPTW results conformed to the results from the PSM analysis.Conclusions and RelevanceIn this large multicenter cohort study of patients with HTG-AP, plasmapheresis was commonly used to lower plasma triglyceride. However, after adjusting for confounders, plasmapheresis was not associated with the incidence and duration of organ failure, but with increased ICU requirements.

show abstract

The Effect of Plasma Triglyceride-Lowering Therapy on the Evolution of Organ Function in Early Hypertriglyceridemia-Induced Acute Pancreatitis Patients With Worrisome Features (PERFORM Study): Rationale and Design of a Multicenter, Prospective, Observational, Cohort Study

Cited by 11 publications

References 35 publications

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Clinical characteristics and early identification of acute pancreatitis in pregnancy with risk for organ failure: a retrospective study

Hyperlipemia pancreatitis onset time affects the association between elevated serum triglyceride levels and disease severity

Early Plasmapheresis Among Patients With Hypertriglyceridemia–Associated Acute Pancreatitis

Contact Info

Product

Resources

About