Polat Fuat, Yaylak Barış, Onuk Tolga, Çalık Ali Nazmi, Akyüz Şükrü, Dayı Şennur Ünal
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Postepy Kardiol Interwencyjnej. 2023 Sep;19(3):217-224. doi: 10.5114/aic.2023.131474. Epub 2023 Sep 27.
Atrial fibrillation (AF) may co-exist in patients with non-ST-elevation myocardial infarction (NSTEMI). In patients with NSTEMI, AF should therefore be regarded as an important risk factor irrespective of its presentation. To predict outcomes in AF patients presenting with NSTEMI, early risk stratification can help to identify the patients with a possible poor long-term prognosis. The development of the PRECISE-DAPT score aimed to predict the risk of bleeding in patients who underwent stent implantation and received dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI), providing a valuable tool for assessing bleeding risk in this specific patient population.
To assess the performance of the PRECISE-DAPT score in predicting long-term prognosis in AF patients with NSTEMI.
Five hundred and twenty-six consecutive AF patients presenting with NSTEMI were included in the present study. The PRECISE-DAPT score was calculated in each case and evaluated for the association of increased mortality in the study population, who survived in-hospital but died in the long term.
All-cause mortality deaths occurred in 278 (52.6%) patients. Higher PRECISE-DAPT score, shorter duration of P2Y12 inhibitor therapy, decreased left ventricular ejection fraction (LVEF), and a history of diabetes mellitus (DM) were all associated with an increased risk of all-cause mortality in the multivariable logistic regression model.
High PRECISE-DAPT score was associated with higher long-term all-cause mortality in AF patients presenting with NSTEMI.
心房颤动(AF)可能与非ST段抬高型心肌梗死(NSTEMI)患者并存。因此,在NSTEMI患者中,无论房颤的表现如何,都应将其视为一个重要的危险因素。为了预测NSTEMI合并房颤患者的预后,早期风险分层有助于识别可能预后不良的长期患者。PRECISE-DAPT评分的开发旨在预测接受支架植入并在经皮冠状动脉介入治疗(PCI)后接受双联抗血小板治疗(DAPT)的患者的出血风险,为评估这一特定患者群体的出血风险提供了一个有价值的工具。
评估PRECISE-DAPT评分在预测NSTEMI合并房颤患者长期预后中的性能。
本研究纳入了526例连续的NSTEMI合并房颤患者。计算每个病例的PRECISE-DAPT评分,并评估研究人群中死亡率增加的相关性,这些患者在住院期间存活但在长期死亡。
278例(52.6%)患者发生全因死亡。在多变量逻辑回归模型中,较高的PRECISE-DAPT评分、较短的P2Y12抑制剂治疗持续时间、降低的左心室射血分数(LVEF)和糖尿病(DM)病史均与全因死亡风险增加相关。
在NSTEMI合并房颤患者中,高PRECISE-DAPT评分与较高的长期全因死亡率相关。