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非 ST 段抬高型急性冠状动脉综合征中风险评分与冠状动脉解剖结构的相关性。

Correlation of risk scores with coronary anatomy in non-ST-elevation acute coronary syndrome.

机构信息

Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.

出版信息

Arq Bras Cardiol. 2013 Jun;100(6):511-7. doi: 10.5935/abc.20130088. Epub 2013 Apr 19.

Abstract

BACKGROUND

The literature lacks studies regarding the correlation between risk scores and coronary anatomy in acute coronary syndrome (ACS) OBJECTIVE: Correlate risk scores with the severity of the coronary lesion in ACS with non-ST elevation.

METHODS

A total of 582 patients were analyzed between July 2004 and October 2006. The correlation between TIMI risk scores and GRACE (hospital and six months) scores was performed for patients with coronary lesion ≥ 50%, using Spearman's non-parametric method. Multiple regression logistics was used to determine the predictive ability of the scores to discriminate to discriminate who will have a coronary lesion ≥ 50%.

RESULTS

Most subjects were male (319 or 54.8%), mean age of 59.9 (± 10.6) years. A positive correlation was observed between risk scores and coronary lesion ≥ 50% (TIMI r = 0.363 [p < 0.0001]; hospital GRACE r = 0.255 [p < 0.0001]; GRACE at six months r = 0.209 [< 0.0001]). The area under the ROC curve for each score to determine to discriminate who will have a coronary lesion > 50% was: TIMI = 0.704 [CI95% 0.656-0.752; p <0.0001]; hospital GRACE = 0.623 [CI95% 0.573-0.673; p < 0.0001]; GRACE at six months= 0.562 [CI95% 0.510-0.613; p ;= 0.0255]. Comparing the areas under the ROC curve, it was found: TIMI versus hospital GRACE: p = 0.01; TIMI versus GRACE at six months:p < 0.0001; hospital GRACE versus GRACE at six months: p = 0.0461.

CONCLUSION

Risk scores correlate with the severity of coronary lesions, and the TIMI risk score showed the best predictive ability.

摘要

背景

文献中缺乏关于急性冠脉综合征(ACS)中风险评分与冠状动脉解剖之间相关性的研究。

目的

分析非 ST 段抬高型 ACS 中风险评分与冠状动脉病变严重程度的相关性。

方法

2004 年 7 月至 2006 年 10 月期间,共分析了 582 例患者。采用 Spearman 非参数法对冠状动脉病变≥50%的患者进行 TIMI 风险评分与 GRACE(住院期间和 6 个月)评分的相关性分析。采用多元回归逻辑分析来确定评分对预测冠状动脉病变≥50%的能力。

结果

大多数患者为男性(319 例,占 54.8%),平均年龄为 59.9(±10.6)岁。风险评分与冠状动脉病变≥50%呈正相关(TIMI r = 0.363[P<0.0001];住院期间 GRACE r = 0.255[P<0.0001];6 个月时 GRACE r = 0.209[P<0.0001])。每个评分预测冠状动脉病变>50%的受试者的 ROC 曲线下面积分别为:TIMI = 0.704[95%CI 0.656-0.752;P<0.0001];住院期间 GRACE = 0.623[95%CI 0.573-0.673;P<0.0001];6 个月时 GRACE = 0.562[95%CI 0.510-0.613;P=0.0255]。比较 ROC 曲线下面积,发现 TIMI 与住院期间 GRACE 比较:P=0.01;TIMI 与 6 个月时 GRACE 比较:P<0.0001;住院期间 GRACE 与 6 个月时 GRACE 比较:P=0.0461。

结论

风险评分与冠状动脉病变严重程度相关,TIMI 风险评分具有最佳的预测能力。

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