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开发用于预测急性心肌梗死幸存者一年死亡率的实验室风险评分模型。

Development of a Laboratory Risk-Score Model to Predict One-Year Mortality in Acute Myocardial Infarction Survivors.

作者信息

Goriki Yuhei, Tanaka Atsushi, Yoshioka Goro, Nishihira Kensaku, Kuriyama Nehiro, Shibata Yoshisato, Node Koichi

机构信息

Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Ureshino 843-0393, Japan.

Department of Cardiovascular Medicine, Saga University, Saga 849-8501, Japan.

出版信息

J Clin Med. 2022 Jun 17;11(12):3497. doi: 10.3390/jcm11123497.

Abstract

The high post-discharge mortality rate of acute myocardial infarction (AMI) survivors is concerning, indicating a need for reliable, easy-to-use risk prediction tools. We aimed to examine if a combined pre-procedural blood testing risk model predicts one-year mortality in AMI survivors. Overall, 1355 consecutive AMI patients who received primary coronary revascularization were divided into derivation (n = 949) and validation (n = 406) cohorts. A risk-score model of parameters from pre-procedural routine blood testing on admission was generated. In the derivation cohort, multivariable analysis demonstrated that hemoglobin < 11 g/dL (odds ratio (OR) 4.01), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (OR 3.75), albumin < 3.8 mg/dL (OR 3.37), and high-sensitivity troponin I > 2560 ng/L (OR 3.78) were significantly associated with one-year mortality after discharge. An increased risk score, assigned from 0 to 4 points according to the counts of selected variables, was significantly associated with higher one-year mortality in both cohorts (p < 0.001). Receiver-operating characteristics curve analyses of risk models demonstrated adequate discrimination between patients with and without one-year death (area under the curve (95% confidence interval) 0.850 (0.756−0.912) in the derivation cohort; 0.820 (0.664−0.913) in the validation cohort). Our laboratory risk-score model can be useful for predicting one-year mortality in AMI survivors.

摘要

急性心肌梗死(AMI)幸存者出院后的高死亡率令人担忧,这表明需要可靠且易于使用的风险预测工具。我们旨在研究术前血液检测综合风险模型是否能预测AMI幸存者的一年死亡率。总体而言,1355例接受直接冠状动脉血运重建的连续AMI患者被分为推导队列(n = 949)和验证队列(n = 406)。生成了一个基于入院时术前常规血液检测参数的风险评分模型。在推导队列中,多变量分析表明,血红蛋白<11 g/dL(比值比(OR)4.01)、估计肾小球滤过率<30 mL/min/1.73 m²(OR 3.75)、白蛋白<3.8 mg/dL(OR 3.37)和高敏肌钙蛋白I>2560 ng/L(OR 3.78)与出院后一年死亡率显著相关。根据所选变量的计数从0到4分分配的风险评分增加,与两个队列中较高的一年死亡率显著相关(p<0.001)。风险模型的受试者工作特征曲线分析表明,在有和没有一年死亡的患者之间有足够的区分度(推导队列中曲线下面积(95%置信区间)为0.850(0.756 - 0.912);验证队列中为0.820(0.664 - 0.913))。我们的实验室风险评分模型可用于预测AMI幸存者的一年死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c816/9224978/1a81b807d467/jcm-11-03497-g001.jpg

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