直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者中斑块特征联合残余SYNTAX评分的预后价值：一项血管内光学相干断层扫描研究
Prognostic value of characteristics of plaque combined with residual syntax score among patients with STEMI undergoing primary PCI: an intravascular optical coherence tomography study.
作者信息
Zhao Xiaoxiao, Wang Ying, Chen Runzhen, Li Jiannan, Zhou Jinying, Liu Chen, Zhou Peng, Sheng Zhaoxue, Chen Yi, Song Li, Zhao Hanjun, Yan Hongbing
机构信息
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, No.167, Beijing, 100037, China.
, Fuwai Hospital, Chinese Academy of Medical Sciences, 12 Langshan Rd, Shenzhen, 518000, China.
出版信息
Thromb J. 2021 Nov 12;19(1):85. doi: 10.1186/s12959-021-00329-z.
AIM
The present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI.
METHODS AND OUTCOMES
A total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P = 0.005), plaque erosion (P = 0.045), macrophage infiltration (P = 0.026), and calcification (P = 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846.
CONCLUSION
The results of this study could be used in clinical practice to support risk stratification.
TRIAL REGISTRATION
This study was registered at ClinicalTrials.gov as NCT03593928 .
目的
本研究旨在探讨急性心肌梗死（MI）患者中这些特征，尤其是薄帽纤维粥样斑块（TCFA）与残余SYNTAX评分（rSS）的关系。
方法和结果
共有434例年龄≥18岁的ST段抬高型心肌梗死（STEMI）患者连续接受了直接经皮冠状动脉介入治疗（PCI）。值得注意的是，与其他亚组相比，罪犯病变中存在TCFA以及较高水平的rSS与主要不良心血管事件（MACE）显著相关。当将rSS分为三组时，在无TCFA（P = 0.005）、斑块侵蚀（P = 0.045）、巨噬细胞浸润（P = 0.026）和钙化（P = 0.002）的亚组中，高rSS水平与MACE的发生率较高相关。ROC曲线的AUC为0.794和0.816，而生存ROC的AUC为0.798和0.846。
结论
本研究结果可用于临床实践以支持风险分层。
试验注册
本研究已在ClinicalTrials.gov上注册，注册号为NCT03593928。
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