ACEF-II评分在预测非ST段抬高型心肌梗死和不稳定型心绞痛患者主要不良心脏事件中的价值
Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina.
作者信息
Ayça Burak, Yüksel Yasin, Yildiz Cennet
机构信息
Cardiology Department, Istanbul Training and Research Hospital, Istanbul, Turkey.
Cardiology Department, Private Reyap Hospital, Istanbul, Turkey.
出版信息
Tex Heart Inst J. 2024 Dec 11;51(2):e238310. doi: 10.14503/THIJ-23-8310. eCollection 2024 Jul-Dec.
BACKGROUND
A score based on age, creatinine level, and ejection fraction as well as hematocrit value and the presence of emergency surgery (ACEF-II) has been proposed to have predictive value for risk stratification in cardiac surgery. This study aimed to evaluate its utility in patients with non-ST-segment elevation myocardial infarction and unstable angina (NSTEMI-ACS) to predict 1-year major adverse cardiac events (MACE).
METHODS
In all, 768 patients with NSTEMI-ACS were enrolled in the study. After propensity score matching, the MACE and control groups comprised 168 patients each. Blood samples were drawn from patients during emergency department admission and hospitalization. The Global Registry of Acute Coronary Events, Acute Coronary Treatment and Intervention Outcome Network Intensive Care Unit risk, ACEF, and ACEF-II scores of each patient were evaluated.
RESULTS
Mean (SD) age of the study population was 63.07 (12.39) years; 547 (71.2%) patients were male. After propensity score matching for 7 variables, a comparison of the matched groups revealed that patients with MACE had higher heart rates and rates of ST-segment deviation, cardiac arrest, and creatinine levels and lower left ventricular ejection fraction and albumin, hemoglobin, hematocrit, systolic blood pressure, and oxygen saturation values. Multivariate logistic regression analysis revealed that ACEF-II score had the highest odds ratio of the evaluated scores, at 1.41 (95% CI, 1.12-1.81; = .005). The ACEF score did not reach statistical significance for the prediction of 1-year MACE according to multivariate analysis. In addition to type of risk score, left ventricular ejection fraction and heart rate had predictive value for 1-year MACE. An ACEF-II score cutoff of 1.82 predicted 1-year MACE, with a sensitivity of 61.2% and a specificity of 76.2%.
CONCLUSION
ACEF-II score, which is easy to calculate, could be used to predict 1-year MACE in patients with NSTEMI-ACS.
背景
基于年龄、肌酐水平、射血分数以及血细胞比容值和急诊手术情况的评分（ACEF-II）已被提出对心脏手术风险分层具有预测价值。本研究旨在评估其在非ST段抬高型心肌梗死和不稳定型心绞痛（NSTEMI-ACS）患者中预测1年主要不良心脏事件（MACE）的效用。
方法
总共768例NSTEMI-ACS患者纳入本研究。经过倾向评分匹配后，MACE组和对照组各有168例患者。在急诊科入院和住院期间采集患者血样。评估每位患者的全球急性冠状动脉事件注册、急性冠状动脉治疗和干预结果网络重症监护病房风险、ACEF和ACEF-II评分。
结果
研究人群的平均（标准差）年龄为63.07（12.39）岁；547例（71.2%）患者为男性。对7个变量进行倾向评分匹配后，匹配组比较显示，发生MACE的患者心率、ST段偏移率、心脏骤停率和肌酐水平较高，而左心室射血分数、白蛋白、血红蛋白、血细胞比容、收缩压和氧饱和度值较低。多因素逻辑回归分析显示，ACEF-II评分在评估的评分中比值比最高，为1.41（95%CI，1.12-1.81；P = 0.005）。根据多因素分析，ACEF评分对1年MACE的预测未达到统计学意义。除风险评分类型外，左心室射血分数和心率对1年MACE具有预测价值。ACEF-II评分临界值为1.82可预测1年MACE，敏感性为61.2%，特异性为76.2%。
结论
易于计算的ACEF-II评分可用于预测NSTEMI-ACS患者的1年MACE。
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