Department of Cardiology, 546642Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, 64259Van Training and Research Hospital, Van, Turkey.
Angiology. 2023 Apr;74(4):357-364. doi: 10.1177/00033197221105753. Epub 2022 May 29.
The aim of this study was to examine the Intermountain Risk Score (IMRS) for short- and long-term mortality in ST elevation myocardial infarction (STEMI) patients and compare it with the well-known risk scores, such as the Thrombolysis in Myocardial Infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE). In this retrospective and cross-sectional study, 1057 consecutive patients with STEMI were evaluated. The end-points of the study were short- and long-term mortality. The overall mortality rate was 16% (n = 170 patients). The IMRS was significantly higher in STEMI patients who did not survive compared with those who survived. According to multivariable COX proportional regression analysis, the IMRS was independently related to both short- (HR: 1.482, 95% CI: 1.325-1.675, p < .001) and long-term mortality (HR: 1.915, 95% CI: 1.711-2.180, p < .001). The comparison of receiver operating characteristic curves revealed that the IMRS had non-inferior predictive capability for short- and long-term mortality than the TIMI and GRACE risk scores. To the best of our knowledge, this is the first study to show that the IMRS can predict short- and long-term prognosis of patients with STEMI. Further, the IMRS' predictive value for overall mortality was non-inferior compared with TIMI and GRACE scores.
本研究旨在检验 12 导联心电图诊断急性下壁心肌梗死罪犯血管的准确性，并与心电图诊断前壁心肌梗死罪犯血管的准确性进行比较。
在这项回顾性队列研究中，我们连续纳入了 233 例因急性 ST 段抬高型心肌梗死（STEMI）接受直接经皮冠状动脉介入治疗（PCI）的患者。所有患者在接受 PCI 前均接受了 12 导联心电图检查。根据 12 导联心电图诊断的罪犯血管部位，将患者分为下壁组和前壁组。主要终点是术后 1 年时的主要不良心血管事件（MACE）发生率，包括心原性死亡、非致死性心肌梗死和再次血运重建。
结果显示，下壁组和前壁组患者的基线特征和冠状动脉病变特征无显著差异。术后 1 年时，下壁组和前壁组患者的 MACE 发生率分别为 12.5%和 8.7%，两组间无显著差异（P = 0.43）。
在接受直接 PCI 的 STEMI 患者中，12 导联心电图诊断罪犯血管部位的准确性与心电图诊断前壁心肌梗死罪犯血管部位的准确性相当。
