Lun Ziheng, He Jiexin, Fu Ming, Yi Shixin, Dong Haojian, Zhang Ying
Department of Cardiovascular Medicine, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
Department of Cardiovascular Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
Clin Cardiol. 2025 Feb;48(2):e70077. doi: 10.1002/clc.70077.
Lung ultrasound (LUS) and the ACEF score (age, creatinine, and ejection fraction) have been shown to be pivotal in predicting an unfavorable prognosis in acute myocardial infarction (AMI).
The aim of this study is to investigate the prognostic value of LUS combined with ACEF score in AMI.
The ACEF score and the total number of B-lines in eight thoracic regions of LUS were calculated. Adverse events were recorded during hospitalization and follow-up, defined as all-cause death and other cardiovascular events. Multivariate logistic regression identified predictors of adverse events during hospitalization. Multivariate Cox regression identified predictors of adverse events during follow-up.
We enrolled 204 patients. The B-lines (adjusted OR 1.08, [95% CI: 1.03-1.13], p < 0.01) and the ACEF score (adjusted OR 2.71 [95% CI: 1.07-6.81], p < 0.05) independently predicted adverse events during hospitalization. The C-index values were 0.81 (p < 0.01) for the ACEF score, 0.81 (p < 0.01) for LUS, and 0.86 (p < 0.01) for their combination. One hundred seventy-one patients were followed up for 12 months (IQR, 8.13-15.93). Both the B-lines (adjusted HR 1.06 [95% CI: 1.03-1.09], p < 0.05) and the ACEF score (adjusted HR 1.95 [95% CI: 1.10-3.43], p < 0.05) remained associated with an increased risk of adverse events during follow-up. The C-index values were 0.74 (p < 0.01) for the ACEF score, 0.73 (p < 0.01) for LUS, and 0.80 (p < 0.01) for their combined predictive ability.
The B-lines and ACEF score are associated with adverse events in AMI patients. When combined, they provide increasing value in assessing the risk of adverse events, which has significant implications for risk stratification.
肺超声（LUS）和ACEF评分（年龄、肌酐和射血分数）已被证明在预测急性心肌梗死（AMI）的不良预后方面至关重要。
本研究的目的是探讨LUS联合ACEF评分在AMI中的预后价值。
计算ACEF评分以及LUS八个胸部区域的B线总数。记录住院期间和随访期间的不良事件，定义为全因死亡和其他心血管事件。多因素逻辑回归确定住院期间不良事件的预测因素。多因素Cox回归确定随访期间不良事件的预测因素。
我们纳入了204例患者。B线（调整后的OR为1.08，[95%CI：1.03-1.13]，p<0.01）和ACEF评分（调整后的OR为2.71[95%CI：1.07-6.81]，p<0.05）独立预测住院期间的不良事件。ACEF评分的C指数值为0.81（p<0.01），LUS为0.81（p<0.01），两者联合为0.86（p<0.01）。171例患者随访12个月（IQR，8.13-15.93）。B线（调整后的HR为1.06[95%CI：1.03-1.09]，p<0.05）和ACEF评分（调整后的HR为1.95[95%CI：1.10-3.43]，p<0.05）在随访期间仍与不良事件风险增加相关。ACEF评分的C指数值为0.74（p<0.01），LUS为0.
