Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
BMC Cardiovasc Disord. 2023 Jul 31;23(1):383. doi: 10.1186/s12872-023-03379-5.
The study aimed to evaluate the prognostic value of relative wall thickness (RWT) in the patients with ST-segment elevation myocardial infarction (STEMI).
A total of 866 patients with STEMI admitted in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from November 2010 to December 2018 were enrolled in the current study retrospectively. Three methods were used to calculate RWT: RWT, RWT and RWT. The included patients were divided according to the median values of RWT, RWT, and RWT, respectively. Survival analysis were performed with Kaplan-Meier plot and multivariate Cox proportional hazard model was established to evaluate the adjusted hazard ratio of the three kinds of RWT for all cause death, cardiac death and MACE (major adverse cardiac death).
There was no significance for the survival analysis between the low and high groups of RWT, RWT and RWT at 30 days and 12 months. Nonetheless, the cumulative incidence of all cause death and cardiac death in the low group of RWT and RWT was higher than those in the high group at 60 months. The cumulative incidence of MACE in the low group of RWT was higher than the high group at 60 months. Multivariate Cox regression model showed that RWT were inversely associated with long-term cardiac death and MACE in STEMI patients. In the subgroup analysis, three calculations of RWT had no predictive value for the patients with anterior myocardial infarction. By contrast, RWT was the most stable independent predictor for the long-term outcomes of the patients with non-anterior myocardial infarction.
RWT, RWT and RWT had no predictive value for the long-term clinical outcomes of patients with anterior myocardial infarction, whereas RWT was a reliable predictor for all cause death, cardiac death and MACE in patients with non-anterior myocardial infarction.
本研究旨在评估相对壁厚度（RWT）在 ST 段抬高型心肌梗死（STEMI）患者中的预后价值。
回顾性纳入 2010 年 11 月至 2018 年 12 月期间在南京大学医学院附属鼓楼医院就诊的 866 例 STEMI 患者。采用三种方法计算 RWT：RWT、RWT 和 RWT。根据 RWT、RWT 和 RWT 的中位数将纳入患者分为低和高 RWT 组。采用 Kaplan-Meier 图进行生存分析，采用多变量 Cox 比例风险模型评估三种 RWT 对全因死亡、心源性死亡和主要不良心脏事件（MACE）的调整风险比。
在 30 天和 12 个月时，RWT、RWT 和 RWT 的低和高 RWT 组之间的生存分析无显著差异。然而，在 60 个月时，RWT 和 RWT 的低 RWT 组的全因死亡和心源性死亡累积发生率均高于高 RWT 组。在 60 个月时，RWT 的低 RWT 组的 MACE 累积发生率高于高 RWT 组。多变量 Cox 回归模型显示，RWT 与 STEMI 患者的长期心源性死亡和 MACE 呈负相关。亚组分析显示，三种 RWT 计算方法对前壁心肌梗死患者均无预测价值。相比之下，RWT 是预测非前壁心肌梗死患者长期预后的最稳定的独立预测因子。
RWT、RWT 和 RWT 对前壁心肌梗死患者的长期临床结局无预测价值，而 RWT 是预测非前壁心肌梗死患者全因死亡、心源性死亡和 MACE 的可靠预测因子。
