CHA2DS2-VASc 评分对 ST 段抬高型心肌梗死患者残余Syntax 评分的预测价值。

The Predictive Value of CHA2DS2-VASc Score on Residual Syntax Score in Patients With ST Segment Elevation Myocardial Infarction.

机构信息

University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul - Turquia.

出版信息

Arq Bras Cardiol. 2022 Sep;119(3):393-399. doi: 10.36660/abc.20210670.

DOI:10.36660/abc.20210670

PMID:35830076

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9438551/

Abstract

BACKGROUND

The CHA2DS2-VASc score is associated with adverse clinical outcomes in patients with cardiovascular disease. The residual Syntax score (rSS) is a scoring tool which has prognostic value in patients with ST segment elevation myocardial infarction (STEMI).

OBJECTIVES

Our aim in this study is to investigate the predictive value of the CHA2DS2-VASc score on rSS in STEMI patients.

METHODS

A total of 688 consecutive patients with STEMI undergoing percutaneous coronary intervention were evaluated. Baseline demographic and clinical variables besides the CHA2DS2-VASc score were assessed. The patients were divided into two groups; patients with rSS of 8 or below as group 1 (509 patients) and more than 8 as group 2 (179 patients). A p-value < 0.05 was considered statistically significant.

RESULTS

The CHA2DS2-VASc score was higher in group 2 [1 (0-2); 1 (1-3), p<0.001] compared to group 1. The incidence of hypertension [151 (29.7%); 73 (40.8%), p=0.006], patients ≥75 years [18 (3.5%); 21 (11.7%), p<0.001], diabetes mellitus [85 (16.7%); 50 (27.9%), p=0.001] and vascular disease [12 (2.4%); 11 (6.1%), p=0.029] were higher in group 2. In multivariate logistic regression analysis, the CHA2DS2-VASc score (OR=1.355; 95%CI=1.171-1.568; p<0.001), age ≥75 years [OR=3.218; 95%CI=1.645-6.295; p=0.001] and diabetes mellitus [OR=1.670; 95%CI=1.091-2.557; p=0.018] were independent predictors of high rSS. The receiver-operating characteristic curve analysis demonstrated that the CHA2DS2-VASc score had good predictive value for high rSS with a cut-off value of 1.5 (area under curve (AUC): 0.611, 95% confidence interval (CI):0.562-0.659, p<0.001).

CONCLUSIONS

The CHA2DS2-VASc score has a predictive value on rSS in patients with STEMI. The CHA2DS2-VASc score was also an independent predictor of higher rSS.

摘要

背景

CHA2DS2-VASc 评分与心血管疾病患者的不良临床结局相关。残余 Syntax 评分（rSS）是一种在 ST 段抬高型心肌梗死（STEMI）患者中具有预后价值的评分工具。

目的

本研究旨在探讨 CHA2DS2-VASc 评分对 STEMI 患者 rSS 的预测价值。

方法

共评估了 688 例连续接受经皮冠状动脉介入治疗的 STEMI 患者。评估了基线人口统计学和临床变量以及 CHA2DS2-VASc 评分。患者被分为两组；rSS 为 8 或以下的患者为组 1（509 例），rSS 大于 8 的患者为组 2（179 例）。p 值<0.05 被认为具有统计学意义。

结果

组 2 的 CHA2DS2-VASc 评分较高[1（0-2）；1（1-3），p<0.001]。组 2 高血压[151（29.7%）；73（40.8%），p=0.006]、年龄≥75 岁[18（3.5%）；21（11.7%），p<0.001]、糖尿病[85（16.7%）；50（27.9%），p=0.001]和血管疾病[12（2.4%）；11（6.1%），p=0.029]的发生率较高。多变量逻辑回归分析显示，CHA2DS2-VASc 评分（OR=1.355；95%CI=1.171-1.568；p<0.001）、年龄≥75 岁（OR=3.218；95%CI=1.645-6.295；p=0.001）和糖尿病（OR=1.670；95%CI=1.091-2.557；p=0.018）是 rSS 较高的独立预测因素。受试者工作特征曲线分析表明，CHA2DS2-VASc 评分对 rSS 具有良好的预测价值，截断值为 1.5（曲线下面积（AUC）：0.611，95%置信区间（CI）：0.562-0.659，p<0.001）。