Goriki Yuhei, Tanaka Atsushi, Yoshioka Goro, Nishihira Kensaku, Kuriyama Nehiro, Shibata Yoshisato, Node Koichi
Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Ureshino 843-0393, Japan.
Department of Cardiovascular Medicine, Saga University, Saga 849-8501, Japan.
J Clin Med. 2022 Jun 17;11(12):3497. doi: 10.3390/jcm11123497.
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.
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。