Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Zhejiang University, Hangzhou, People's Republic of China.
Medicine (Baltimore). 2022 Jul 22;101(29):e29491. doi: 10.1097/MD.0000000000029491.
The Gensini score (GS) is a convenient, powerful tool for assessing the severity and complexity of coronary artery diseases. Our research investigated the relationship between the GS and periprocedural myocardial infarction (PMI). We recruited 4949 patients (3366 men, 1583 women; mean age 66.45 ± 10.09 years) with a single coronary artery revascularization. Based on the tertile of the GS 20 and 36, the population was divided into 3 groups: Low Group (0 < GS ≤ 20, N = 1809); Intermediate Group (20 < GS ≤ 36, N = 1579); High Group (GS > 36, N = 1561). PMI3 represented the endpoint for cTnI > 3-fold upper reference limit, while PMI5 represented the endpoint for cTnI > 5-fold upper reference limit. The incidence of PMI of High Group was statistically higher than that of Intermediate Group (P < .05), while that of Intermediate Group was statistically higher than Low Group (P < .05). With the adjustment of some general variables, GS was an independent significantly predictor for PMI3 (β = 0.006, P < .05) and PMI5 (β = 0.007, P < .05). Following receiver operating characteristic curve analysis, the optimal cut-off value to predict PMI are 22.5 for PMI3 and 27 for PMI5. The GS was an independent predictor of PMI in the single-coronary revascularization population. Additionally, the 22.5 of GS was the optimal cut-off value for determining the presence of PMI3, while the 27 of GS for PMI5.
积分系统（GS）是评估冠状动脉疾病严重程度和复杂性的便捷、强大的工具。我们的研究调查了 GS 与围手术期心肌梗死（PMI）之间的关系。我们招募了 4949 名接受单一冠状动脉血运重建的患者（3366 名男性，1583 名女性；平均年龄 66.45±10.09 岁）。根据 GS 的三分位数 20 和 36，人群被分为 3 组：低分组（0<GS≤20，N=1809）；中分组（20<GS≤36，N=1579）；高分组（GS>36，N=1561）。PMI3 代表 cTnI 超过 3 倍上参考限的终点，而 PMI5 代表 cTnI 超过 5 倍上参考限的终点。高分组的 PMI 发生率明显高于中分组（P<.05），而中分组明显高于低分组（P<.05）。在调整了一些一般变量后，GS 是 PMI3（β=0.006，P<.05）和 PMI5（β=0.007，P<.05）的独立显著预测因子。通过受试者工作特征曲线分析，预测 PMI 的最佳截断值为 22.5 时用于 PMI3，27 时用于 PMI5。GS 是单支冠状动脉血运重建人群 PMI 的独立预测因子。此外，GS 的 22.5 是确定 PMI3 存在的最佳截断值，而 GS 的 27 是用于 PMI5 的最佳截断值。
