Chan Pin Yin Dean, Azzahhafi Jaouad, James Stefan
Department of Cardiology, St. Antonius Hospital Nieuwegein, 3435CM Nieuwegein, The Netherlands.
Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, 751 85 Uppsala, Sweden.
J Clin Med. 2020 Sep 21;9(9):3039. doi: 10.3390/jcm9093039.
Risk scores are widely used in patients with acute coronary syndrome (ACS) prior to treatment decision-making at different points in time. At initial hospital presentation, risk scores are used to assess the risk for developing major adverse cardiac events (MACE) and can guide clinicians in either discharging the patients at low risk or swiftly admitting and treating the patients at high risk for MACE. During hospital admission, risk assessment is performed to estimate mortality, residual ischemic and bleeding risk to guide further in-hospital management (e.g., timing of coronary angiography) and post-discharge management (e.g., duration of dual antiplatelet therapy). In the months and years following ACS, long term risk can also be assessed to evaluate current treatment strategies (e.g., intensify or reduce pharmaceutical treatment options). As multiple risk scores have been developed over the last decades, this review summarizes the most relevant risk scores used in ACS patients.
风险评分在急性冠状动脉综合征(ACS)患者治疗决策的不同时间点被广泛应用。在患者首次入院时,风险评分用于评估发生主要不良心脏事件(MACE)的风险,并可指导临床医生对低风险患者进行出院处理,或迅速收治并治疗MACE高风险患者。在住院期间,进行风险评估以估计死亡率、残余缺血和出血风险,从而指导进一步的院内管理(如冠状动脉造影的时机)和出院后管理(如双联抗血小板治疗的持续时间)。在ACS后的数月和数年里,也可评估长期风险以评估当前的治疗策略(如强化或减少药物治疗方案)。由于在过去几十年中已开发出多种风险评分,本综述总结了ACS患者中使用的最相关的风险评分。