Goto Hiroki, Saito Yuichi, Yaginuma Hiroaki, Asada Kazunari, Sato Takanori, Hashimoto Osamu, Kitahara Hideki, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Hospital.
Department of Cardiology, Chiba Emergency and Psychiatric Medical Center.
J Atheroscler Thromb. 2025 Jul 1;32(7):853-862. doi: 10.5551/jat.65162. Epub 2024 Dec 26.
Several risk-scoring models, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, have been developed to predict recurrent cerebrovascular events in patients with ischemic stroke. As myocardial infarction (MI) and ischemic stroke are both atherosclerotic diseases, these scoring models in the field of cerebrovascular disease may be applicable and useful for risk stratification in patients with acute MI. We therefore evaluated the diagnostic ability and clinical applicability of these stroke risk scores in predicting atherosclerotic events after acute MI.
This multicenter retrospective study included 2016 patients with acute MI who underwent percutaneous coronary intervention and survived to discharge. The three risk-scoring models were calculated, and their diagnostic ability for major adverse cardiovascular events (MACE) after discharge, a composite of cardiovascular death, recurrent MI, and ischemic stroke, was evaluated.
During the median follow-up of 523 days, 218 (10.8%) patients experienced MACE after discharge. High values for Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II were progressively associated with an increased risk of MACE after discharge. Overall, the diagnostic abilities of the three risk scores were similar.
Risk prediction models in the field of ischemic stroke, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, were useful in stratifying MACE risk in patients with acute MI. Risk-scoring models for atherosclerotic cardiovascular disease may be applicable to patient populations with other cardiovascular diseases in different arterial territories.
已经开发了几种风险评分模型，包括福冈卒中风险评分、埃森卒中风险评分和卒中预后工具II，用于预测缺血性卒中患者复发性脑血管事件。由于心肌梗死（MI）和缺血性卒中都是动脉粥样硬化疾病，这些脑血管疾病领域的评分模型可能适用于急性心肌梗死患者的风险分层并具有实用价值。因此，我们评估了这些卒中风险评分在预测急性心肌梗死后动脉粥样硬化事件方面的诊断能力和临床适用性。
这项多中心回顾性研究纳入了2016例接受经皮冠状动脉介入治疗并存活至出院的急性心肌梗死患者。计算了三种风险评分模型，并评估了它们对出院后主要不良心血管事件（MACE）的诊断能力，MACE是心血管死亡、复发性心肌梗死和缺血性卒中的综合指标。
在中位随访523天期间，218例（10.8%）患者出院后发生了MACE。福冈卒中风险评分、埃森卒中风险评分和卒中预后工具II的高分与出院后MACE风险增加逐渐相关。总体而言，三种风险评分的诊断能力相似。
缺血性卒中领域的风险预测模型，包括福冈卒中风险评分、埃森卒中风险评分和卒中预后工具II，有助于对急性心肌梗死患者的MACE风险进行分层。动脉粥样硬化性心血管疾病的风险评分模型可能适用于不同动脉区域患有其他心血管疾病的患者群体。
