非ST段抬高型心肌梗死患者中H2FPEF与SYNTAX评分的关系。
The relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction.
作者信息
Bayam Emrah, Kalçık Macit, Öztürkeri Burak, Yıldırım Ersin, Karaduman Ahmet, Kalkan Semih, Küp Ayhan, Günay Nuran, Güner Ahmet, Kahyaoğlu Muzaffer, Uyan Cihangir
机构信息
Depertament of Cardiology, University of Medical Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey.
Depertament of Cardiology, Faculty of Medicine, Hitit University, Çorum, Turkey.
出版信息
Acta Cardiol. 2021 Oct;76(8):870-877. doi: 10.1080/00015385.2020.1796319. Epub 2020 Jul 24.
BACKGROUND
The Synergy between Percutaneous Coronary Intervention (SYNTAX) score, has been used to estimate the extent and complexity of coronary artery disease (CAD). The H2FPEF score enables robust discrimination of heart failure with preserved ejection fraction (HFpEF) from non-cardiac aetiologies of dyspnea. In the present study, we aimed to investigate the relationship between H2FPEF and SYNTAX scores in patients with non-ST elevation myocardial infarction (NSTEMI).
METHOD
Two hundred eighty two consecutive patients with NSTEMI who underwent coronary angiographic examination were enrolled in this study. The H2FPEF score was calculated for each patient on admission. All patients underwent coronary angiography within 2 days following their admission. The SYNTAX scoring system was used to evaluate the severity and extent of CAD.
RESULTS
The mean H2FPEF Score [3(2-4) vs 1(0.5-1.5), < .001] and the frequencies of diabetes mellitus, hypertension and, atrial fibrillation were significantly higher and LVEF was significantly lower in patients with high SYNTAX score. High H2FPEF Score (OR: 3.61, 95%CI: 2.64-4.93; = .001) and low left ventricular ejection fraction (OR: 0.94, 95%CI: 0.89-0.98; = .013) were found to be independent associates for high SYNTAX score. H2FPEF Score above a cut-off level of 2.5 predicted high SYNTAX score with a sensitivity of 80% and a specificity of 82.5% (AUC: 0.890; 95%CI: 0.848-0.931; < .001). There was a significant and moderate positive correlation between H2FPEF and SYNTAX Scores ( = 0.694, < .001).
CONCLUSION
High H2FPEF score may be associated with high SYNTAX score and may be used to estimate the extent and complexity of CAD in NSTEMI patients.
背景
SYNTAX（经皮冠状动脉介入治疗协同作用）评分已被用于评估冠状动脉疾病（CAD）的范围和复杂性。H2FPEF评分能够有效地区分射血分数保留的心力衰竭（HFpEF）与非心脏原因引起的呼吸困难。在本研究中，我们旨在探讨非ST段抬高型心肌梗死（NSTEMI）患者中H2FPEF与SYNTAX评分之间的关系。
方法
本研究纳入了282例连续接受冠状动脉造影检查的NSTEMI患者。每位患者入院时计算H2FPEF评分。所有患者在入院后2天内接受冠状动脉造影。采用SYNTAX评分系统评估CAD的严重程度和范围。
结果
高SYNTAX评分患者的平均H2FPEF评分[3（2 - 4）对1（0.5 - 1.5），P <.001]以及糖尿病、高血压和心房颤动的发生率显著更高，而左心室射血分数显著更低。高H2FPEF评分（比值比：3.61，95%置信区间：2.64 - 4.93；P =.001）和低左心室射血分数（比值比：0.94，95%置信区间：0.89 - 0.98；P =.013）被发现是高SYNTAX评分的独立相关因素。H2FPEF评分高于2.5的临界值预测高SYNTAX评分的敏感性为80%，特异性为82.5%（曲线下面积：0.890；95%置信区间：0.848 - 0.931；P <.001）。H2FPEF与SYNTAX评分之间存在显著的中度正相关（r = 0.694，P <.001）。
结论
高H2FPEF评分可能与高SYNTAX评分相关，可用于评估NSTEMI患者CAD的范围和复杂性。
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