Department of Cardiology, Bakırcay University Cigli Training and Research Hospital.
Department of Cardiology, Dokuz Eylul University Faculty of Medicine.
Int Heart J. 2023 Sep 30;64(5):791-797. doi: 10.1536/ihj.23-024. Epub 2023 Sep 13.
The MAPH (mean platelet volume, age, total protein and hematocrit) score is a newly developed simple scoring system for patients with STEMI that has been associated with satisfactory predictive values to determine thrombus burden in STEMI patients. Therefore, the aim of our study was to determine the relationship between the MAPH risk score and TIMI flow in patients with STEMI.The study included 260 patients who underwent primary percutaneous coronary intervention between December 2019 to July 2022, and had TIMI 0 flow in the responsible coronary artery due to STEMI. According to the TIMI flow score after stent implantation, the patients were classified into either the no-reflow group (n = 59) or the normal flow group (n = 201). In order to calculate the MAPH score, ROC analysis was performed to find the cutoff point for each component of the MAPH score. MAPH scores were calculated (MPV + Age + Protein + Hematocrit) for both groups. Our study was a retrospective, observational study.In the multivariable regression analysis, the MAPH score (OR: 0.567; 95%CI: 0.330-0.973, P = 0.04) and glycoprotein IIb/IIIa inhibitors (OR: 0.249; 95%CI: 0.129-0.483, P < 0.001) were parameters found to be independent predictors of TIMI flow. An MAPH score value > 2.5 predicted the presence of low TIMI coronary flow in patients with STEMI, with 78% specificity and 45% sensitivity (ROC area under curve: 0.691, 95% CI: 0.617-0.766, P < 0.001).The MAPH risk score is simple, inexpensive, and quick to calculate. A high MAPH score may be an indicator of coronary no-reflow in patients with STEMI.
MAPH(平均血小板体积、年龄、总蛋白和红细胞压积)评分是一种新开发的用于 STEMI 患者的简单评分系统,与确定 STEMI 患者血栓负荷的满意预测值相关。因此,我们的研究目的是确定 MAPH 风险评分与 STEMI 患者 TIMI 血流之间的关系。
该研究纳入了 2019 年 12 月至 2022 年 7 月期间接受直接经皮冠状动脉介入治疗的 260 例 STEMI 患者,由于 STEMI,其相关冠状动脉 TIMI 血流为 0 级。根据支架植入后的 TIMI 血流评分,将患者分为无复流组(n = 59)和正常血流组(n = 201)。为了计算 MAPH 评分,进行了 ROC 分析以找到 MAPH 评分各成分的截断值。计算了两组的 MAPH 评分(MPV+年龄+蛋白+红细胞压积)。我们的研究是一项回顾性、观察性研究。
多变量回归分析显示,MAPH 评分(OR:0.567;95%CI:0.330-0.973,P = 0.04)和糖蛋白 IIb/IIIa 抑制剂(OR:0.249;95%CI:0.129-0.483,P < 0.001)是 TIMI 血流的独立预测因素。MAPH 评分>2.5 预测 STEMI 患者存在低 TIMI 冠状动脉血流,特异性为 78%,敏感性为 45%(ROC 曲线下面积:0.691,95%CI:0.617-0.766,P < 0.001)。
MAPH 风险评分简单、廉价且计算迅速。高 MAPH 评分可能是 STEMI 患者无复流的指标。