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梗死相关动脉罪犯病变的血管造影特征以及心肌梗死溶栓治疗(TIMI)评分与Syntax评分的相关性,以预测接受直接经皮冠状动脉介入治疗患者的冠状动脉疾病范围和严重程度。

Angiographic characteristics of culprit lesions in infarct related artery and correlation of TIMI score with SYNTAX score to predict extent and severity of coronary artery disease in patients undergoing primary percutaneous coronary interventions.

作者信息

Sial Jawaid Akbar, Ali Nasir, Shehzad M

机构信息

Rizwanullah, FCPS Post Fellow Interventional Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.

Jawaid Akbar Sial, FCPS Professor of Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):20-25. doi: 10.12669/pjms.40.1.7750.

Abstract

OBJECTIVE

The current study was designed to explore the relationship of TIMI and SYNTAX risk score to predict the CAD extent and severity in STEMI patients.

METHODS

For this cross-sectional study, 304 STEMI patients undergoing PPCI were enrolled at Department of Interventional Cardiology NICVD Karachi from September 2021 to January 2022. and the TIMI risk score was determined at enrolment. Based on these scorings, the patients were grouped as low, intermediate, and high risk, i.e., a score of ≤ 3, 4 to 7, and ≥ 8, respectively. The SYNTAX scores were utilized to assess the extent of CAD.

RESULTS

Statistically significant difference was found in symptoms to balloon time (p=0.001), history of diabetes (p=0.006), angina (p=0.011), obesity (p=0.048), STEMI type (p=0.003), Killip classes (p=0.000), Infarct-Related Artery (p=0.006), number of diseased vessels (p<0.01), LMS > 50% (p=0.000), PCI type (p<0.01), collateral circulation (p<0.01), In-hospital mortality (p<0.01), LV support (p<0.01), and post-procedural TIMI flow (p=0.013), among the three TIMI risk groups. Significant correlation was found among TIMI risk score and SYNTAX score.

CONCLUSION

It is observed that the TIMI risk scores are highly correlated with the SYNTAX Score in predicting the CAD severity in STEMI patients.

摘要

目的

本研究旨在探讨心肌梗死溶栓治疗(TIMI)和SYNTAX风险评分与预测ST段抬高型心肌梗死(STEMI)患者冠状动脉疾病(CAD)范围及严重程度之间的关系。

方法

在本横断面研究中,2021年9月至2022年1月期间,在卡拉奇国家心血管疾病研究所介入心脏病科纳入了304例行急诊经皮冠状动脉介入治疗(PPCI)的STEMI患者,并在入组时确定TIMI风险评分。根据这些评分,将患者分为低、中、高风险组,即评分分别≤3、4至7和≥8。利用SYNTAX评分评估CAD的范围。

结果

在症状至球囊扩张时间(p = 0.001)、糖尿病史(p = 0.006)、心绞痛(p = 0.011)、肥胖(p = 0.048)、STEMI类型(p = 0.003)、Killip分级(p = 0.000)、梗死相关动脉(p = 0.006)、病变血管数量(p < 0.01)、左主干狭窄> 50%(p = 0.000)、PCI类型(p < 0.01)、侧支循环(p < 0.01)、院内死亡率(p < 0.01)、左心室支持(p < 0.01)和术后TIMI血流(p = 0.013)方面,三个TIMI风险组之间存在统计学显著差异。TIMI风险评分与SYNTAX评分之间存在显著相关性。

结论

观察到在预测STEMI患者CAD严重程度方面,TIMI风险评分与SYNTAX评分高度相关。

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