CHA2DS2-VASC 评分与急性 ST 段抬高型心肌梗死患者住院期间心血管不良事件的相关性研究。
Association of CHA2DS2-VASC Score with in-Hospital Cardiovascular Adverse Events in Patients with Acute ST-Segment Elevation Myocardial Infarction.
机构信息
Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei 230011, Anhui, China.
Hefei Second People's Hospital Affiliated to Bengbu Medical College, Department of Cardiology, Hefei 230011, Anhui, China.
出版信息
Int J Clin Pract. 2022 Sep 23;2022:3659381. doi: 10.1155/2022/3659381. eCollection 2022.
BACKGROUND
Acute ST-elevation myocardial infarction (STEMI) is a common clinical critical illness, and accurate, reliable, simple, and easy-to-remember tools are needed in clinical practice to quickly identify the risk of this condition in STEMI patients. This study investigates the predictive value of the admission CHA2DS2-VASc score for in-hospital MACE in STEMI patients.
METHODS
A total of 210 STEMI patients who visited the Chest Pain Center of the Second People's Hospital of Hefei from December 2019 to December 2021 were retrospectively analyzed. They were divided into MACE and non-MACE groups. The receiver operating characteristic curve (ROC) was used to assess the predictive value of the CHA2DS2-VASc score for MACE events during hospitalization.
RESULTS
The CHA2DS2-VASc score was higher in the MACE group than in the non-MACE group ( < 0.05), and multivariate logistic regression analysis showed that the CHA2DS2-VASc score was an independent risk factor for MACE events during hospitalization in STEMI patients (OR = 1.391, 95%CI 1.044-1.853, =0.024); ROC curve analysis showed that the area under the curve (AUC) of the CHA2DS2-VASc score was 0.744, the sensitivity was 0.64, the specificity was 0.694, and the optimal cutoff value was 3.5 in predicting the risk of MACE events during hospitalization in STEMI patients. There were no significant differences between the GRACE score (0.744 VS.0.827) and TIMI score (0.744VS.0.745) ( > 0.05).
CONCLUSION
The CHA2DS2-VASc score can successfully predict the occurrence of in-hospital MACE events in STEMI patients.
背景
急性 ST 段抬高型心肌梗死（STEMI）是一种常见的临床急危重症，临床工作中需要准确、可靠、简便、易记的工具来快速识别 STEMI 患者的发病风险。本研究旨在探讨入院时 CHA2DS2-VASc 评分对 STEMI 患者住院期间发生主要不良心血管事件（MACE）的预测价值。
方法
回顾性分析 2019 年 12 月至 2021 年 12 月在合肥市第二人民医院胸痛中心就诊的 210 例 STEMI 患者，根据住院期间是否发生 MACE 将其分为 MACE 组和非 MACE 组。采用受试者工作特征曲线（ROC）评估 CHA2DS2-VASc 评分对 STEMI 患者住院期间 MACE 事件的预测价值。
结果
MACE 组患者的 CHA2DS2-VASc 评分高于非 MACE 组（ < 0.05），多因素 logistic 回归分析显示，CHA2DS2-VASc 评分是 STEMI 患者住院期间发生 MACE 事件的独立危险因素（OR=1.391，95%CI 1.044~1.853， =0.024）；ROC 曲线分析显示，CHA2DS2-VASc 评分预测 STEMI 患者住院期间发生 MACE 事件的曲线下面积（AUC）为 0.744，敏感度为 0.64，特异度为 0.694，最佳截断值为 3.5；CHA2DS2-VASc 评分预测 STEMI 患者住院期间发生 MACE 事件的效能与 GRACE 评分（0.744 VS.0.827）和 TIMI 评分（0.744 VS.0.745）比较差异均无统计学意义（ > 0.05）。
结论
CHA2DS2-VASc 评分可成功预测 STEMI 患者住院期间发生 MACE 事件。
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