Department of Cardiology, Liaocheng People's Hospital, Shandong University, Jinan, Shandong, P.R. China.
Department of Cardiology, Liaocheng People's Hospital Affiliated to Shandong First Medical University, Liaocheng, Shandong, P.R. China.
Clin Cardiol. 2023 Aug;46(8):950-957. doi: 10.1002/clc.24071. Epub 2023 Jul 10.
This study aimed to explore the predictive value of CHA DS -VASc score for in-hospital major adverse cardiac events (MACEs) in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary artery intervention.
A total of 746 STEMI patients were divided into four groups according to CHA DS -VASc score (1, 2-3, 4-5, >5). The predictive ability of the CHA DS -VASc score for in-hospital MACE was made. Subgroup analysis was made between gender differences.
In a multivariate logistic regression analysis model including creatinine, total cholesterol, and left ventricular ejection fraction, CHA DS -VASc score was an independent predictor of MACE as a continuous variable (adjusted odds ratio: 1.43, 95% confidence interval [CI]: 1.27-1.62, p < .001). As a category variable, using the lowest CHA DS -VASc score of 1 as a reference, CHA DS -VASc score 2-3, 4-5, >5 groups for predicting MACE was 4.62 (95% CI: 1.94-11.00, p = .001), 7.74 (95% CI: 3.18-18.89, p < .001), and 11.71 (95% CI: 4.14-33.15, p < .001). The CHA DS -VASc score was also an independent risk factor for MACE in the male group, either as a continuous variable or category variable. However, CHA DS -VASc score was not a predictor of MACE in the female group. The area under the curve value of the CHA DS -VASc score for predicting MACE was 0.661 in total patients (74.1% sensitivity and 50.4% specificity [p < .001]), 0.714 in the male group (69.4% sensitivity and 63.1% specificity [p < .001]), but there was no statistical significance in the female group.
CHA DS -VASc score could be considered as a potential predictor of in-hospital MACE with STEMI, especially in males.
本研究旨在探讨 CHA DS -VASc 评分对行直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死（STEMI）患者院内主要不良心脏事件（MACE）的预测价值。
根据 CHA DS -VASc 评分（1、2-3、4-5、>5），将 746 例 STEMI 患者分为 4 组。对 CHA DS -VASc 评分对院内 MACE 的预测能力进行了分析。并进行了性别差异的亚组分析。
在包括肌酐、总胆固醇和左心室射血分数的多变量逻辑回归分析模型中，CHA DS -VASc 评分是 MACE 的独立预测因素，呈连续变量（校正比值比：1.43，95%置信区间[CI]：1.27-1.62，p < 0.001）。作为分类变量，以最低的 CHA DS -VASc 评分为 1 为参考，CHA DS -VASc 评分 2-3、4-5、>5 组预测 MACE 的比值分别为 4.62（95%CI：1.94-11.00，p = 0.001）、7.74（95%CI：3.18-18.89，p < 0.001）和 11.71（95%CI：4.14-33.15，p < 0.001）。CHA DS -VASc 评分也是男性组 MACE 的独立危险因素，无论是作为连续变量还是分类变量。然而，CHA DS -VASc 评分不是女性组 MACE 的预测因素。CHA DS -VASc 评分预测 MACE 的曲线下面积值在总患者中为 0.661（74.1%的敏感性和 50.4%的特异性[p < 0.001]），在男性组中为 0.714（69.4%的敏感性和 63.1%的特异性[p < 0.001]），但在女性组中无统计学意义。
CHA DS -VASc 评分可作为预测 STEMI 患者院内 MACE 的潜在指标，尤其适用于男性。
