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接受经皮冠状动脉介入治疗的急性心肌梗死患者入院时休克指数的长期预后意义

Long-Term Prognostic Implications of the Admission Shock Index in Patients With Acute Myocardial Infarction Who Received Percutaneous Coronary Intervention.

作者信息

Abe Naoyuki, Miura Takashi, Miyashita Yusuke, Hashizume Naoto, Ebisawa Soichiro, Motoki Hirohiko, Tsujimura Takuya, Ishihara Takayuki, Uematsu Masaaki, Katagiri Toshio, Ishihara Ryuma, Tosaka Atsushi, Ikeda Uichi

机构信息

1 Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

2 Department of Cardiology, Kansai Rosai Hospital Cardiovascular Center, Hyogo, Japan.

出版信息

Angiology. 2017 Apr;68(4):339-345. doi: 10.1177/0003319716653885. Epub 2016 Jul 11.

Abstract

The admission shock index (SI) enables prediction of short-term prognosis. This study investigated the prognostic implications of admission SI for predicting long-term prognoses for acute myocardial infarction (AMI). The participants were 680 patients with AMI who received percutaneous coronary intervention. Shock index is the ratio of heart rate and systolic blood pressure. Patients were classified as admission SI <0.66 (normal) and ≥0.66 (elevated; 75th percentile). The end point was 5-year major adverse cardiac events (MACEs). Elevated admission SI was seen in 176 patients. Peak creatine kinase levels were significantly higher and left ventricular ejection fraction was lower in the elevated SI group, which had a worse MACEs. In multivariate Cox regression analysis, SI ≥0.66 was a risk factor for MACE. Elevated admission SI was associated with poorer long-term prognosis.

摘要

入院休克指数(SI)能够预测短期预后。本研究调查了入院SI对预测急性心肌梗死(AMI)长期预后的影响。研究对象为680例接受经皮冠状动脉介入治疗的AMI患者。休克指数是心率与收缩压的比值。患者被分为入院SI<0.66(正常)和≥0.66(升高;第75百分位数)两组。终点为5年主要不良心脏事件(MACE)。176例患者入院SI升高。SI升高组的肌酸激酶峰值水平显著更高,左心室射血分数更低,其MACE情况更差。在多变量Cox回归分析中,SI≥0.66是MACE的危险因素。入院SI升高与较差的长期预后相关。

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