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肺动脉收缩压升高对急性心肌梗死患者短期预后的影响。

Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients With Acute Myocardial Infarction.

机构信息

Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Emergency ICU, Linyi People's Hospital, Linyi, Shandong, China.

出版信息

Angiology. 2020 Jul;71(6):567-572. doi: 10.1177/0003319720909056. Epub 2020 Mar 4.

Abstract

Pulmonary artery systolic pressure (PASP) may increase because of cardiac alterations that result in increased filling pressures after acute myocardial infarction (AMI). We hypothesized that PASP might be a useful maker to predict the risk of cardiac death after AMI. We carried out a retrospective study from 2013 to 2017 involving 5401 patients with AMI. Patients were grouped according to their admission PASP result, and the primary end point was cardiac death in 6 months after AMI. Pulmonary artery systolic pressure was associated with age, AMI site, Killip classification, and decreased ejection fraction. After adjustments for clinical and echocardiographic parameters in a Cox model, PASP was found to be significantly related to cardiac death. In receiver operating characteristic analysis, PASP >30 mm Hg had a sensitivity of 59.8% and a specificity of 62.5% for predicting 6-month cardiac death after AMI. In conclusion, PASP at the index admission may be a useful marker predicting short-term cardiac death. These results have implications for future research and management of patients with AMI.

摘要

肺动脉收缩压(PASP)可能会升高,因为急性心肌梗死(AMI)后心脏改变导致充盈压升高。我们假设 PASP 可能是预测 AMI 后心脏死亡风险的有用标志物。我们进行了一项回顾性研究,涉及 2013 年至 2017 年的 5401 名 AMI 患者。根据入院时的 PASP 结果将患者分组,主要终点是 AMI 后 6 个月的心脏死亡。PASP 与年龄、AMI 部位、Killip 分级和射血分数降低有关。在 Cox 模型中调整临床和超声心动图参数后,发现 PASP 与心脏死亡显著相关。在受试者工作特征分析中,PASP>30mmHg 对预测 AMI 后 6 个月心脏死亡的敏感性为 59.8%,特异性为 62.5%。总之,入院时的 PASP 可能是预测短期心脏死亡的有用标志物。这些结果对 AMI 患者的未来研究和管理具有重要意义。

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