Stanojkovic Ana, Mrdovic Igor, Tosic Ivana, Matic Dragan, Savic Lidija, Petrovic Jelena, Cirkovic Andja, Milosevic Aleksandra, Srdic Milena, Kostic Natasa, Rankovic Ivan, Petrusic Igor
Health Center Aleksinac, 18220 Aleksinac, Serbia.
Coronary Care Unit, Emergency Hospital, Clinical Center of Serbia, 11000 Belgrade, Serbia.
J Clin Med. 2025 Apr 16;14(8):2727. doi: 10.3390/jcm14082727.
Non-ST-segment elevation acute myocardial infarction (NSTEMI) represents a heterogeneous patient population with varying risks of adverse outcomes. The RISK-PCI score, initially developed for ST-segment elevation myocardial infarction (STEMI) patients, was evaluated for its prognostic value in NSTEMI patients undergoing percutaneous coronary intervention (PCI). A retrospective observational study of 242 NSTEMI patients treated with PCI at the Clinical Center of Serbia from June 2011 to June 2016 was conducted. The RISK-PCI score, incorporating clinical, echocardiographic, and angiographic variables, was calculated for each patient. The primary outcome was 30-day major adverse cardiovascular events (MACE). Secondary outcomes included individual components of MACE. Statistical analyses were performed to assess the predictive value of the RISK-PCI score. The primary outcome of 30-day MACE occurred in 9.9% of patients. Independent predictors of 30-day MACE included age > 75 years, glucose ≥ 6.6 mmol/L, creatinine clearance < 60 mL/min, and post-procedural TIMI flow < 3. The RISK-PCI score demonstrated good discrimination for 30-day MACE (AUC = 0.725). Patients stratified into the very high-risk group (RISK-PCI score ≥ 7) had significantly higher risks of 30-day MACE (29.4%). The RISK-PCI score effectively stratifies NSTEMI patients by their risk of 30-day MACE, identifying a very high-risk subgroup that may benefit from closer monitoring and tailored interventions. External validation on larger cohorts is recommended to confirm these findings.
非ST段抬高型急性心肌梗死（NSTEMI）患者群体异质性强，不良结局风险各异。最初为ST段抬高型心肌梗死（STEMI）患者开发的RISK-PCI评分，在接受经皮冠状动脉介入治疗（PCI）的NSTEMI患者中进行了预后价值评估。对2011年6月至2016年6月在塞尔维亚临床中心接受PCI治疗的242例NSTEMI患者进行了一项回顾性观察研究。为每位患者计算了包含临床、超声心动图和血管造影变量的RISK-PCI评分。主要结局是30天主要不良心血管事件（MACE）。次要结局包括MACE的各个组成部分。进行统计分析以评估RISK-PCI评分的预测价值。30天MACE的主要结局发生在9.9%的患者中。30天MACE的独立预测因素包括年龄>75岁、血糖≥6.6 mmol/L、肌酐清除率<60 mL/min以及术后TIMI血流<3级。RISK-PCI评分对30天MACE具有良好的区分度（AUC = 0.725）。分层为极高风险组（RISK-PCI评分≥7）的患者30天MACE风险显著更高（29.4%）。RISK-PCI评分可根据NSTEMI患者30天MACE风险有效分层，识别出可能受益于密切监测和针对性干预的极高风险亚组。建议在更大队列中进行外部验证以证实这些发现。
