Pan Jiazhi, Zhang Qiuxia, Lei Li, Chen Yaode, Li Guodong, Liang Hongbin, Lu Junyan, Zhang Xinlu, Tang Yongzhen, Pu Jun, Yang Yining, Mo Dapeng, Xiu Jiancheng
Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, China.
Front Cardiovasc Med. 2022 Apr 12;9:807805. doi: 10.3389/fcvm.2022.807805. eCollection 2022.
To explore the relationship between the severity of coronary artery disease (CAD) and the occurrence of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with acute myocardial infarction (AMI).
We retrospectively enrolled 705 patients with AMI, who were hospitalized and underwent percutaneous coronary intervention (PCI), in Nanfang Hospital from July 2017 to July 2020. Logistic regression analysis and backward stepwise approach were taken to select the correlation factors. The left and the receiver operating characteristic curves (ROC) analysis were plotted to observe the discriminative power of the SYNTAX score (SS)/caFFR-guided functional SS (FSS) on the incident VT/VF.
About 58 (8.2%) patients experienced life-threatening VT/VF. The FSS (OR: 1.155; 95% CI: 1.047 to 1.273; = 0.004) was an independent predictor of VT/VF after AMI. The ROC analysis showed that the discriminative power of FSS on the incident VT/VF was significantly better than SS (0.759 vs.0.695, < 0.0001). Patients with VT/VF were categorized into 2 groups according to the interval between the onset of AMI and the VT/VF. The logistic regression analysis revealed that FSS was a significant independent correlation of early- and late-VT/VF.
The incident VT/VF in patients with AMI is closely associated with the severity of CAD evaluated by SS and FSS. Compared to SS, FSS has a higher correlation with VT/VF, and FSS was demonstrated to be an independent correlation factor of incident VT/VF after AMI.
探讨急性心肌梗死（AMI）患者冠状动脉疾病（CAD）的严重程度与室性心动过速/心室颤动（VT/VF）发生之间的关系。
我们回顾性纳入了2017年7月至2020年7月在南方医院住院并接受经皮冠状动脉介入治疗（PCI）的705例AMI患者。采用逻辑回归分析和向后逐步法选择相关因素。绘制左心室和受试者工作特征曲线（ROC）分析，以观察SYNTAX评分（SS）/基于计算机血流储备分数引导的功能性SS（FSS）对VT/VF事件的判别能力。
约58例（8.2%）患者发生危及生命的VT/VF。FSS（比值比：1.155；95%可信区间：1.047至1.273；P = 0.004）是AMI后VT/VF的独立预测因素。ROC分析表明，FSS对VT/VF事件的判别能力显著优于SS（0.759对0.695，P < 0.0001）。根据AMI发作与VT/VF之间的间隔，将发生VT/VF的患者分为两组。逻辑回归分析显示，FSS是早期和晚期VT/VF的显著独立相关因素。
AMI患者发生的VT/VF与通过SS和FSS评估的CAD严重程度密切相关。与SS相比，FSS与VT/VF的相关性更高，并且FSS被证明是AMI后发生VT/VF的独立相关因素。
