Liu Yuanhui, Wang Litao, Lin Yaowang, Chen Wei, Xu Zhengrong, Chen Pengyuan, Dai Yining, Zeng Lihuan, Fan Hualin, Xue Ling, Chen Jiyan, Tan Ning, Duan Chongyang, He Pengcheng
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
Front Cardiovasc Med. 2021 May 28;8:675142. doi: 10.3389/fcvm.2021.675142. eCollection 2021.
Post-acute myocardial infarction (post-AMI) infection is an infrequent but important and serious complication in patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Predicting its occurrence is essential for future prevention. However, little is known about the prediction of post-AMI infection in such patients to date. This study aims to develop and validate a new risk score based on risk factors for early prediction of infection in STEMI patients undergoing PCI. This prospective, multi-center and observational study assesses the predictive value of risk score for post-AMI infection among a cohort of patients hospitalized due to STEMI. The STEMI patients undergoing PCI enrolled between January 1st 2010 and May 31st 2016 were served as a development cohort while those enrolled from June 1st 2016 to May 31st 2018 were served as validation cohort. The primary endpoint was post-AMI infection during hospitalization, defined as infection requiring antibiotics (reflecting the clinical influence of infection compatible with the necessity for additional treatment), and all-cause death and major adverse cardiovascular events (MACE) including all-cause death, recurrent myocardial infarction, target vessel revascularization, and stroke were considered as secondary endpoints. The risk score model based on risk factors was established using stepwise logistic regression, and will be validated in other centers and external patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). This study will provide evidence on prognostic property, reliability of scoring, comparative performance, and suitability of the novel model for screening purpose in order to be recommended for clinical practice. Our study is designed to develop and validate a clinical risk score for predicting infection in participants with STEMI who have undergone PCI. This simple tool may therefore improve evaluation of post-AMI infection and enhance future researches into the best practices to prevent or reduce infection in such patients. www.chictr.org.cn, identifier: ChiCTR1900028278.
急性心肌梗死后（post-AMI）感染是接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中一种少见但重要且严重的并发症。预测其发生对于未来的预防至关重要。然而，迄今为止，对于此类患者急性心肌梗死后感染的预测知之甚少。本研究旨在基于危险因素开发并验证一种新的风险评分，用于早期预测接受PCI的STEMI患者的感染情况。 这项前瞻性、多中心观察性研究评估了风险评分对因STEMI住院的一组患者急性心肌梗死后感染的预测价值。2010年1月1日至2016年5月31日期间接受PCI的STEMI患者作为开发队列，2016年6月1日至2018年5月31日期间纳入的患者作为验证队列。主要终点是住院期间的急性心肌梗死后感染，定义为需要使用抗生素的感染（反映感染的临床影响以及额外治疗的必要性），全因死亡和主要不良心血管事件（MACE）包括全因死亡、再发心肌梗死、靶血管血运重建和卒中被视为次要终点。基于危险因素的风险评分模型采用逐步逻辑回归建立，并将在其他中心和非ST段抬高型急性冠状动脉综合征（NSTE-ACS）的外部患者中进行验证。 本研究将提供关于新模型的预后特性、评分可靠性、比较性能和筛查适用性的证据，以便推荐用于临床实践。 我们的研究旨在开发并验证一种临床风险评分，用于预测接受PCI的STEMI参与者的感染情况。因此，这个简单的工具可能会改善对急性心肌梗死后感染的评估，并加强对预防或减少此类患者感染的最佳实践的未来研究。 中国临床试验注册中心，标识符：ChiCTR1900028278。
