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那不勒斯预后评分对接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者急性肾损伤的预测价值

Predictive Value of the Naples Prognostic Score for Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

作者信息

Karakoyun Suleyman, Cagdas Metin, Celik Aziz Inan, Bezgin Tahir, Tanboga Ibrahim H, Karagoz Ali, Cınar Tufan, Dogan Remziye, Saygi Mehmet, Oduncu Vecih

机构信息

Department of Cardiology, Akademi Hospital, Kocaeli, Turkey.

Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey.

出版信息

Angiology. 2024 Jul;75(6):576-584. doi: 10.1177/00033197231161922. Epub 2023 Mar 8.

Abstract

The purpose of this investigation was to investigate whether there was an association between the Naples prognostic score and the development of acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients following primary percutaneous coronary intervention (pPCI). The study comprised 2901 consecutive STEMI patients who had pPCI. For each patient, the Naples prognostic score was determined. To evaluate the predictive performance of the Naples score (which included either continuous and categorical variables), we developed a Nested model and a nested model combined with the Naples score. The Naples prognostic score was the most significant predictor of AKI occurrence after admission creatinine, age, and contrast volume. The continuous Naples prognostic score model provided the best prediction performance and discriminative ability. The C-index of the Nested and full models with continuous Naples prognostic score were significantly higher than that of the Nested model. The decision curve analysis found that the overall model had a higher full range of probability of clinical net benefit than the baseline model, with a 10% AKI likelihood. The present study found that the Naples prognostic score may be useful to predict the risk of AKI in STEMI patients undergoing pPCI.

摘要

本研究的目的是调查那不勒斯预后评分与接受直接经皮冠状动脉介入治疗(pPCI)的ST段抬高型心肌梗死(STEMI)患者急性肾损伤(AKI)的发生之间是否存在关联。该研究纳入了2901例连续接受pPCI的STEMI患者。为每位患者确定那不勒斯预后评分。为评估那不勒斯评分(包括连续变量和分类变量)的预测性能,我们构建了一个嵌套模型以及一个结合那不勒斯评分的嵌套模型。那不勒斯预后评分是入院时肌酐、年龄和造影剂用量之后AKI发生的最显著预测因素。连续的那不勒斯预后评分模型具有最佳的预测性能和鉴别能力。具有连续那不勒斯预后评分的嵌套模型和完整模型的C指数显著高于嵌套模型。决策曲线分析发现,总体模型在临床净获益的全概率范围内比基线模型更高,AKI发生可能性为10%。本研究发现,那不勒斯预后评分可能有助于预测接受pPCI的STEMI患者发生AKI的风险。

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