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回顾性研究评估格拉斯哥预后评分与冠状动脉旁路移植术后 30 天和 1 年时的房颤、卒中和死亡率之间的关系。

A Retrospective Study to Evaluate the Association Between the Glasgow Prognostic Score and Atrial Fibrillation, Stroke, and Mortality at 30 Days and at 1 Year After Coronary Artery Bypass Graft Surgery.

机构信息

Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey.

Department of Cardiovascular Surgery, Bagcilar Training and Research Hospital, İstanbul, Turkey.

出版信息

Med Sci Monit. 2023 Jan 31;29:e939283. doi: 10.12659/MSM.939283.

Abstract

BACKGROUND The Glasgow prognostic score (GPS) consists of a combination of serum C-reactive protein and albumin levels as indicators of systematic inflammatory response and nutritional status, respectively. The present retrospective study aimed to evaluate the association between the GPS and atrial fibrillation, stroke, and mortality at 30 days and 1 year after coronary artery bypass graft (CABG) surgery. MATERIAL AND METHODS Patients with chronic coronary syndromes who underwent CABG surgery between 2012 and 2019 in a single center were included. Preoperative GPS was calculated. Then, patients were grouped according to postoperative atrial fibrillation (POAF) development. Further, groups were formed to evaluate the relationship between GPS and 30-day and 1-year cardiovascular mortality as well as stroke development. RESULTS Patients who developed POAF had higher GPS, higher European System for Cardiac Operative Risk Evaluation (EuroSCORE II) score, advanced age, lower angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) use, lower left ventricular ejection fraction, and were more likely to be female and to have a history of carotid artery disease (P<0.05, for all). Additionally, GPS, EuroSCORE II, advanced age, and lower left ventricular ejection fraction were detected as independent risk factors for POAF development. When adverse outcomes were assessed, cardiovascular mortality at 30 days or 1 year, and stroke development at 1 year, were more frequent in patients with POAF. Moreover, POAF development was found to be an independent risk factor for adverse outcomes. Also, GPS was established as an independent risk factor both for 30-day and 1-year cardiovascular mortality (P<0.0001 and P=0.001, respectively). CONCLUSIONS GPS is an easy-to-calculate score that has reasonable diagnostic accuracy in determining the risk of POAF and stroke as well as 30-day and 1-year cardiovascular mortality.

摘要

背景

格拉斯哥预后评分(GPS)由血清 C 反应蛋白和白蛋白水平的组合组成,分别作为系统性炎症反应和营养状况的指标。本回顾性研究旨在评估 GPS 与冠状动脉旁路移植术(CABG)后 30 天和 1 年的心房颤动、中风和死亡率之间的关系。

材料和方法

纳入 2012 年至 2019 年在一家单中心接受 CABG 手术的慢性冠状动脉综合征患者。计算术前 GPS。然后,根据术后心房颤动(POAF)的发展对患者进行分组。进一步,形成组以评估 GPS 与 30 天和 1 年心血管死亡率以及中风发展之间的关系。

结果

发生 POAF 的患者 GPS 更高,欧洲心脏手术风险评估系统(EuroSCORE II)评分更高,年龄较大,血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(ACEI/ARB)使用率较低,左心室射血分数较低,且更可能为女性,并有颈动脉疾病史(P<0.05,均)。此外,GPS、EuroSCORE II、年龄较大和较低的左心室射血分数被检测为 POAF 发展的独立危险因素。当评估不良结局时,POAF 患者在 30 天或 1 年时的心血管死亡率以及 1 年时的中风发生率更高。此外,POAF 的发生被确定为不良结局的独立危险因素。此外,GPS 是 30 天和 1 年心血管死亡率的独立危险因素(P<0.0001 和 P=0.001)。

结论

GPS 是一种易于计算的评分,在确定 POAF 和中风以及 30 天和 1 年心血管死亡率的风险方面具有合理的诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45da/9898998/e32aafb02ef3/medscimonit-29-e939283-g001.jpg

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