Chen Difang, Lu Mei, Fu Zhaoming, Ding Kejun, Liang Peng
Department of Cardiology, Zhuji People's Hospital of Zhejiang Province, Zhuji, China.
Department of Intensive Care Unit, Huai'an Hospital of Huai'an City, Huai'an, China.
J Thorac Dis. 2023 May 30;15(5):2721-2728. doi: 10.21037/jtd-23-562. Epub 2023 May 26.
The model for end-stage liver disease (MELD) score is a marker used to evaluate end-stage liver disease in patients with liver failure and is suggested to be valuable in evaluating heart diseases such as heart failure. Because patients with heart failure and myocardial infarction often use anticoagulants, there is an impact on the international normalized ratio (INR). Therefore, removing the INR from MELD score to form MELD-XI score may help to more accurately evaluate the cardiac function in patients with heart failure. This study was conducted to examine the predictive value of MELD-XI score in patients with acute myocardial infarction after coronary artery stenting, as there is a lack of literature in this area.
The data of 318 patients with acute myocardial infarction admitted to The People's Hospital of Dazu from January 2018 to January 2021 was retrospectively collected. According to the MELD-XI score on admission, the patients were divided into a high-MELD-XI score group (n=159) and a low-MELD-XI score group (n=159). The patients were followed up for 1 year after surgery to observe the long-term prognosis and the long-term prognosis of the 2 groups was compared.
Compared with that in the low-MELD-XI score group, the left ventricular ejection fraction in the high-MELD-XI score group was significantly reduced (51.61%±7.66% 60.48%±5.94%; P<0.001), while the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) increased significantly (821.58±461.81 723.51±335.16 ng; P=0.031). The MELD-XI score had a certain predictive value for heart failure in patients with acute myocardial infarction after coronary artery stenting, and the area under the curve was 0.730 (95% CI: 0.670-0.791; P<0.001). The MELD-XI score had a predictive value for death in patients with acute myocardial infarction after coronary artery stenting, and the area under the curve was 0.704 (95% CI: 0.564-0.843; P=0.022). MELD-XI score was significantly negatively correlated with left ventricular ejection fraction in patients with acute myocardial infarction after coronary artery stenting (r=-0.444; P<0.001).
MELD-XI could evaluate the cardiac function of patients with acute myocardial infarction after coronary artery stenting, which was valuable in predicting the prognosis.
终末期肝病模型(MELD)评分是用于评估肝衰竭患者终末期肝病的一项指标,且有人认为其在评估心力衰竭等心脏病方面具有价值。由于心力衰竭和心肌梗死患者常使用抗凝剂,这会对国际标准化比值(INR)产生影响。因此,从MELD评分中去除INR以形成MELD-XI评分,可能有助于更准确地评估心力衰竭患者的心脏功能。本研究旨在探讨MELD-XI评分在冠状动脉支架置入术后急性心肌梗死患者中的预测价值,因为该领域缺乏相关文献。
回顾性收集了2018年1月至2021年1月大足区人民医院收治的318例急性心肌梗死患者的数据。根据入院时的MELD-XI评分,将患者分为高MELD-XI评分组(n = 159)和低MELD-XI评分组(n = 159)。术后对患者进行1年随访,观察远期预后,并比较两组的远期预后。
与低MELD-XI评分组相比,高MELD-XI评分组的左心室射血分数显著降低(51.61%±7.66%对60.48%±5.94%;P<0.001),而N末端B型利钠肽原(NT-proBNP)水平显著升高(821.58±461.81对723.51±335.16 ng;P = 0.031)。MELD-XI评分对冠状动脉支架置入术后急性心肌梗死患者的心力衰竭具有一定的预测价值,曲线下面积为0.730(95%CI:0.670 - 0.791;P<0.001)。MELD-XI评分对冠状动脉支架置入术后急性心肌梗死患者的死亡具有预测价值,曲线下面积为0.704(95%CI:0.564 - 0.843;P = 0.022)。MELD-XI评分与冠状动脉支架置入术后急性心肌梗死患者的左心室射血分数显著负相关(r = -0.444;P<0.001)。
MELD-XI可评估冠状动脉支架置入术后急性心肌梗死患者的心脏功能,对预测预后具有重要价值。