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评价壁运动评分指数和 SYNTAX 评分 II 在经皮冠状动脉介入治疗后 12 个月随访时主要不良心血管事件对急性冠状动脉综合征患者的预后作用。

Evaluation of the Prognostic Role of the Wall Motion Score Index and the SYNTAX Score II in Patients with Acute Coronary Syndrome Following Percutaneous Coronary Intervention by Evaluation of Major Adverse Cardiovascular Events at 12-Month Follow-Up.

机构信息

Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).

出版信息

Med Sci Monit. 2021 Nov 6;27:e932652. doi: 10.12659/MSM.932652.

Abstract

BACKGROUND This study aimed to evaluate the wall motion score (WMS) index and the SYNTAX score II (SSII) in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI) by evaluation of major adverse cardiovascular events (MACEs) at the 12-month follow-up at a single center. MATERIAL AND METHODS An observational study of 430 patients with ACS undergoing PCI at the Second Affiliated Hospital of Soochow University over a 1-year period was performed. Baseline data including WMS and SSII were recorded and compared with the rates of MACEs in the study group. WMS and SSII were stratified by the tercile from low to high. RESULTS Both WMS and SSII were associated with the rates of MACEs (P<0.001 and P=0.003, respectively). The incidence of MACEs was positively correlated with terciles of the WMS and SSII groups (3.7% vs 1.6% vs 7.0% [P<0.001] and 2.6% vs 5.8% vs 11.6% [P<0.001], lowest to highest, respectively). Logistic regression analyses identified combined predictors for 12-month outcome, including WMS and SSII. The use of a model combining both scores yielded a higher predictive value (area under the curve [AUC]=0.78; 95% confidence interval [CI], 0.733-0.835; P<0.001) than the use of either score alone. Using WMSs alone, the AUC was 0.73 (95% CI, 0.660-0.793; P<0.001). Using SSII alone, the AUC was 0.71 (95% CI, 0.649-0.769; P<0.001). CONCLUSIONS This study showed that the combined methods of the WMS index and the SSII were predictive factors of MACEs in patients with ACS following PCI at the 12-month follow-up.

摘要

背景 本研究旨在评估经皮冠状动脉介入治疗(PCI)后急性冠状动脉综合征(ACS)患者的壁运动评分(WMS)指数和 SYNTAX 评分 II(SSII),并在单一中心进行 12 个月随访时评估主要不良心血管事件(MACEs)。

材料与方法 对在苏州大学第二附属医院进行 PCI 的 430 例 ACS 患者进行了为期 1 年的观察性研究。记录基线数据,包括 WMS 和 SSII,并与研究组的 MACE 发生率进行比较。WMS 和 SSII 按从低到高的三分位数分层。

结果 WMS 和 SSII 均与 MACE 发生率相关(P<0.001 和 P=0.003)。MACE 发生率与 WMS 和 SSII 三分位组呈正相关(3.7%比 1.6%比 7.0%[P<0.001]和 2.6%比 5.8%比 11.6%[P<0.001],从低到高)。多因素逻辑回归分析确定了 12 个月结局的联合预测因子,包括 WMS 和 SSII。使用联合评分的模型可获得更高的预测值(曲线下面积[AUC]=0.78;95%置信区间[CI],0.733-0.835;P<0.001),优于单独使用任一评分。单独使用 WMSs,AUC 为 0.73(95%CI,0.660-0.793;P<0.001)。单独使用 SSII,AUC 为 0.71(95%CI,0.649-0.769;P<0.001)。

结论 本研究表明,WMS 指数和 SSII 的联合方法是 PCI 后 12 个月 ACS 患者发生 MACE 的预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b28/8579602/87bc97ccf033/medscimonit-27-e932652-g001.jpg

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