CHA2DS2-VASc评分对药物洗脱支架植入患者支架内再狭窄的预测价值
The Predictive Value of the CHA2DS2-VASc Score for In-Stent Restenosis Among Patients with Drug-Eluting Stents Implantation.
作者信息
Zhao Jinbo, Hou Ling, Zhu Ni, Huang Rui, Su Ke, Lei Yuhua, Li Yuanhong
机构信息
Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, Hubei Province, 445000, People's Republic of China.
Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, 442000, People's Republic of China.
出版信息
Int J Gen Med. 2023 Jan 5;16:69-76. doi: 10.2147/IJGM.S391312. eCollection 2023.
OBJECTIVE
The CHA2DS2-VASc score, a system which has been initially recommended for the assessment of thromboembolic risk in patients with atrial fibrillation (AF), arouses attention in the field of adverse coronary events. The purpose of this study was to explore the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients after drug-eluting stent (DES) implantation.
METHODS
To further investigate the relationship between CHA2DS2-VASc scores and ISR after DES, a retrospective study of DES was carried on. Additionally, the preoperative variables for the ISR and control groups were contrasted. Predictive factors were chosen using the optimal subset regression. We validate the model using internal validation. The prediction model was evaluated using the receiver operator characteristic (ROC) analysis.
RESULTS
We used a 3:7 ratio to create an experimental group and a validation group, and then ran a stepwise regression with the data from each of the two groups. The results showed that CHA2DS2-VASc score was an independent risk factor for ISR in both the experimental (p = 0.0139) and validation groups (p = 0.0014), and both had significant predictive value for ISR. The area of the ROC curve was greater than 0.5 in both groups (AUC = 0.78, 0.719, respectively) indicating that the model fit was good in both groups.
CONCLUSION
The CHA2DS2-VASc score is a reliable predictor of in-stent restenosis (ISR) after DES implantation.
目的
CHA2DS2-VASc评分系统最初被推荐用于评估心房颤动（AF）患者的血栓栓塞风险，目前在不良冠状动脉事件领域引起了关注。本研究的目的是探讨术前CHA2DS2-VASc评分对药物洗脱支架（DES）植入术后患者支架内再狭窄（ISR）的预测价值。
方法
为进一步研究DES术后CHA2DS2-VASc评分与ISR之间的关系，对DES进行了回顾性研究。此外，对比了ISR组和对照组的术前变量。使用最优子集回归选择预测因素。我们使用内部验证对模型进行验证。使用受试者工作特征（ROC）分析对预测模型进行评估。
结果
我们以3:7的比例创建了一个实验组和一个验证组，然后对两组的数据进行逐步回归。结果显示，CHA2DS2-VASc评分在实验组（p = 0.0139）和验证组（p = 0.0014）中均为ISR的独立危险因素，且对ISR均具有显著的预测价值。两组的ROC曲线面积均大于0.5（AUC分别为0.78、0.719），表明两组模型拟合良好。
结论
CHA2DS2-VASc评分是DES植入术后支架内再狭窄（ISR）的可靠预测指标。
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