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基于休克指数的风险指数对接受经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者院内结局预测的比较。

Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

作者信息

Wang Guoyu, Wang Ruzhu, Liu Ling, Wang Jing, Zhou Lei

机构信息

Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province, Nanjing, China.

Department of Cardiology, Taizhou People's Hospital, Jiangsu Province, Taizhou, China.

出版信息

J Int Med Res. 2021 Mar;49(3):3000605211000506. doi: 10.1177/03000605211000506.

Abstract

OBJECTIVE

We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

METHODS

A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia.

RESULTS

Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications.

CONCLUSIONS

The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.

摘要

目的

我们旨在确定对于接受直接经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者,休克指数(SI)及其衍生指标预测不良结局的价值是否优于心肌梗死溶栓风险指数(TRI)。

方法

在一项回顾性队列研究中,分析了2018年1月至2019年6月期间共257例接受直接PCI的STEMI患者。计算入院时的SI、改良休克指数(MSI)、年龄SI(年龄×SI)、年龄MSI(年龄×MSI)和TRI。临床终点为住院并发症,包括全因死亡率、急性心力衰竭、心源性休克、机械并发症、再梗死和危及生命的心律失常。

结果

多因素分析显示,入院时高SI、MSI、年龄SI、年龄MSI和TRI与住院并发症发生率显著升高相关。年龄SI和年龄MSI预测住院并发症的价值与TRI相当(受试者工作特征曲线下面积:z分别为1.313和0.882)。

结论

对于接受直接PCI的STEMI患者,年龄SI和年龄MSI在预测住院并发症方面似乎与TRI相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ad/8020253/f5138af6d9ca/10.1177_03000605211000506-fig1.jpg

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