Fan Xuefang, Li Mingliang, Cao Jie, Liang Zeming
Department of Cardiology, Xianyang Hospital of Yan'an University, Xianyang, Shanxi 712000, P.R. China.
Ward No. 2, Department of Cardiovascular Disease, People's Hospital of Hanzhong City, Hanzhong, Shanxi 723000, P.R. China.
Exp Ther Med. 2021 Dec;22(6):1464. doi: 10.3892/etm.2021.10899. Epub 2021 Oct 20.
The thrombolysis in myocardial infarction (TIMI) risk index has been indicated to be a simple and useful tool for risk stratification of patients with ST-elevation myocardial infarction (STEMI). However, the predictive value of the TIMI risk index regarding the long-term outcome for patients with STEMI with multiple vessel disease has remained to be determined. In the present study, a total of 369 patients diagnosed with STEMI who received emergency percutaneous coronary intervention treatment were analyzed. A five-year follow-up was performed to record the primary endpoint of all-cause mortality, as well as the secondary endpoints of myocardial infarction, stroke, emergent revascularization and admission due to heart failure. A receiver operating characteristic (ROC) curve was used to determine the cut-off value of the TIMI risk index for predicting all-cause death, based on which the patients were divided into a high TIMI group and a low TIMI group. Kaplan-Meier survival curves were used to compare the long-term survival of the two groups and multivariate Cox regression analysis was used to evaluate the predictive value of the risk factors regarding primary and secondary endpoints. The ROC curve indicated that the TIMI risk index was associated with three-year all-cause death with a cut-off value of 30.35 (area under curve, 0.705; P=0.001). The high TIMI group (>30.35) and low TIMI group (<30.35) exhibited a significant difference in all-cause death (P=0.009) but not in any of the secondary endpoints (P=0.527). Multivariate Cox regression analysis demonstrated that a high TIMI risk index was an independent risk factor for all-cause death in patients with STEMI and multiple-vessel disease (hazard ratio=3.709, 95% CI: 1.521-9.046, P=0.004). In conclusion, the TIMI risk index was associated with long-term outcomes for patients with STEMI and multiple-vessel disease and may be of value for risk prediction.
心肌梗死溶栓（TIMI）风险指数已被证明是对ST段抬高型心肌梗死（STEMI）患者进行危险分层的一种简单且有用的工具。然而，TIMI风险指数对于多支血管病变的STEMI患者长期预后的预测价值仍有待确定。在本研究中，共分析了369例诊断为STEMI并接受急诊经皮冠状动脉介入治疗的患者。进行了为期五年的随访，以记录全因死亡率这一主要终点，以及心肌梗死、中风、急诊血运重建和因心力衰竭入院这些次要终点。采用受试者工作特征（ROC）曲线来确定TIMI风险指数预测全因死亡的临界值，并据此将患者分为高TIMI组和低TIMI组。采用Kaplan-Meier生存曲线比较两组的长期生存率，并采用多因素Cox回归分析评估危险因素对主要和次要终点的预测价值。ROC曲线表明，TIMI风险指数与三年全因死亡相关，临界值为30.35（曲线下面积，0.705；P=0.001）。高TIMI组（>30.35）和低TIMI组（<30.35）在全因死亡方面存在显著差异（P=0.009），但在任何次要终点方面均无差异（P=0.527）。多因素Cox回归分析表明，高TIMI风险指数是多支血管病变的STEMI患者全因死亡的独立危险因素（风险比=3.709，95%CI：1.521-9.046，P=0.004）。总之，TIMI风险指数与多支血管病变的STEMI患者的长期预后相关，可能对风险预测有价值。
