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MAPH评分对确定非ST段抬高型心肌梗死患者血栓负荷的预测价值。

The predictive value of MAPH score for determining thrombus burden in patients with non-ST segment elevation myocardial infarction.

作者信息

Çakmak Karaaslan Özge, Çöteli Cem, Özilhan Murat Oğuz, Akdi Ahmet, Başyiğit Funda, Selçuk Hatice, Selçuk Mehmet Timur, Maden Orhan

机构信息

Department of Cardiology, Ankara Bilkent City Hospital, Health Sciences University, Ankara, Turkey.

Department of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Egypt Heart J. 2022 Aug 15;74(1):60. doi: 10.1186/s43044-022-00299-1.

Abstract

BACKGROUND

A high thrombus burden has been connected with poor clinical events in patients with non-ST segment elevation myocardial infarction (NSTEMI). In patients with STEMI, a high MAPH score has been associated with a large thrombus burden. However, the predictive value of the MAPH score in determining the thrombus burden in patients with NSTEMI is unclear. The present report aimed to evaluate the prognostic role of the MAPH score in the estimating coronary thrombus burden in NSTEMI patients. The study patients were split into two groups according to their thrombus grade. The low shear rate (LSR) and high shear rate (HSR) were estimated by haematocrit levels and serum total protein levels. The MAPH score was calculated by adding mean platelet volume (MPV) levels and age, in addition to total protein and haematocrit.

RESULTS

The patients with a high thrombus burden (HTB) had a higher LSR, higher HSR and higher MAPH score compared to patients with low thrombus burden. MAPH score was found to be an independent predictors of HTB in Model 1 (OR: 1.124, 95% CI: 1.011-1.536; p = 0.039) and Model 2 (OR: 1.236; 95% CI: 1.002-1.525; p = 0.047). The cut-off value of the MAPH score for predicting HTB was 2 based on the Youden index.

CONCLUSIONS

The MAPH score, which calculated by adding MPV levels and age, in addition to total protein and haematocrit, is a novel, easily accessible score. The MAPH score at both LSR and HSR was an independent predictor of HTB.

摘要

背景

在非ST段抬高型心肌梗死(NSTEMI)患者中,高血栓负荷与不良临床事件相关。在ST段抬高型心肌梗死(STEMI)患者中,高MAPH评分与大血栓负荷相关。然而,MAPH评分在确定NSTEMI患者血栓负荷方面的预测价值尚不清楚。本报告旨在评估MAPH评分在估计NSTEMI患者冠状动脉血栓负荷中的预后作用。根据血栓分级将研究患者分为两组。通过血细胞比容水平和血清总蛋白水平估计低剪切率(LSR)和高剪切率(HSR)。除总蛋白和血细胞比容外,MAPH评分通过将平均血小板体积(MPV)水平和年龄相加来计算。

结果

与低血栓负荷患者相比,高血栓负荷(HTB)患者的LSR、HSR和MAPH评分更高。在模型1(OR:1.124,95%CI:1.011 - 1.536;p = 0.039)和模型2(OR:1.236;95%CI:1.002 - 1.525;p = 0.047)中,MAPH评分被发现是HTB的独立预测因子。基于约登指数,预测HTB的MAPH评分临界值为2。

结论

MAPH评分通过将MPV水平、年龄以及总蛋白和血细胞比容相加来计算,是一种新颖且易于获得的评分。LSR和HSR时的MAPH评分均是HTB的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03aa/9378801/18923df4d704/43044_2022_299_Fig1_HTML.jpg

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