ΣΔST/ΔHR指数对经皮冠状动脉介入术后再狭窄的预测价值

The Predictive Value of ΣΔST/ΔHR Index for Restenosis after Percutaneous Coronary Intervention.

作者信息

Kim Chul, Choi Hee Eun

机构信息

Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 139-707, Korea.

出版信息

Ann Rehabil Med. 2012 Aug;36(4):544-50. doi: 10.5535/arm.2012.36.4.544. Epub 2012 Aug 27.

DOI:10.5535/arm.2012.36.4.544

PMID:22977781

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3438422/

Abstract

OBJECTIVE

To find out the predictive value of the ΣΔST/ΔHR index for restenosis after percutaneous coronary intervention (PCI).

METHOD

Subjects of this research were patients who participated in a cardiac rehabilitation (CR) program as six to eight weeks of a hospital-based program after receiving PCI to treat acute coronary syndrome (ACS). The patients received coronary angiography (CAG) at the onset of the ACS and nine months after that, and also received an exercise tolerance test (ETT) at the start of the CR program and several days before receiving a follow-up CAG. In ETT, we used the sum of the ST depression (ΣΔST index) of leads II, III, aVF, V(4-6) as well as the sum of the ΔST/ΔHR (heart rate) (ΣΔST/ΔHR index) in the same leads and the sum of the ΔST/ΔRPP (rate pressure product) (ΣΔST/ΔRPP index) in the same leads. We compared the predictive power of each index of ETT for restenosis after PCI.

RESULTS

The sensitivity, specificity, positive predictive value, and negative predictive value of ΣΔST index were 69%, 47%, 31%, and 82%. The ΣΔST/ΔHR index was 13.7±5.2 in the restenosis group and 9.3±5.6 in the patent group (p=0.017). The sensitivity, specificity, positive predictive value, and negative predictive value of this index were 85%, 63%, 44%, and 92%. The ΣΔST/ΔRPP index were 0.10±0.08 in the restenosis group and 0.06±0.04 in the patent group (p=0.016). The sensitivity, specificity, positive predictive value, and negative predictive value of this index were 54%, 76%, 44%, and 83%.

CONCLUSION

The ΣΔST/ΔHR index showed a much higher sensitivity and negative predictive value for restenosis after PCI compared to the ΣΔST index.

摘要

目的

探讨ΣΔST/ΔHR指数对经皮冠状动脉介入治疗（PCI）后再狭窄的预测价值。

方法

本研究的对象是在接受PCI治疗急性冠状动脉综合征（ACS）后，参加为期6至8周的医院心脏康复（CR）项目的患者。患者在ACS发病时及之后9个月接受冠状动脉造影（CAG），并在CR项目开始时及接受随访CAG前几天接受运动耐量测试（ETT）。在ETT中，我们使用II、III、aVF、V(4-6)导联的ST段压低总和（ΣΔST指数），以及同一导联的ΔST/ΔHR（心率）总和（ΣΔST/ΔHR指数）和同一导联的ΔST/ΔRPP（率压积）总和（ΣΔST/ΔRPP指数）。我们比较了ETT各指数对PCI后再狭窄的预测能力。

结果

ΣΔST指数的敏感性、特异性、阳性预测值和阴性预测值分别为69%、47%、31%和82%。再狭窄组的ΣΔST/ΔHR指数为13.7±5.2，通畅组为9.3±5.6（p=0.017）。该指数的敏感性、特异性、阳性预测值和阴性预测值分别为85%、63%、44%和92%。再狭窄组的ΣΔST/ΔRPP指数为0.10±0.08，通畅组为0.06±0.04（p=0.016）。该指数的敏感性、特异性、阳性预测值和阴性预测值分别为54%、76%、44%和83%。