摘要
目的建立急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后5年以上再次血运重建的造影前预测模型。方法对连续纳入的296例PCI术后5年以上ACS患者进行回顾性研究,多因素分析找出再次血运重建的独立危险因素,针对相应回归系数进行赋分。结果胸痛、肌钙蛋白I>0.03 ng/ml、首次PCI年龄≤60岁、首次PCI时冠脉初始狭窄程度≥90%和既往冠脉多支病变是ACS患者首次PCI术后5年以上需要再次血运重建的独立危险因素。赋分:胸痛计5分,肌钙蛋白I>0.03 ng/ml计1分,首次PCI年龄≤60岁计1分,首次PCI时冠脉初始狭窄程度≥90%计2分,既往冠脉多支病变计1分。以预测评分为检验变量、再次血运重建为状态变量绘制受试者工作特征(ROC)曲线,其曲线下面积(AUC)值为0.822。结论本预测评分可以用于造影前评估ACS患者PCI术后5年以上再次血运重建的个体化风险。
AIM To develop a pre-angiographic prediction model of the need for revascularization in patients after percutaneous coronary intervention(PCI) for acute coronary syndrome(ACS) over 5 years.METHODS A retrospective study was conducted in 296 consecutive patients who had undergone PCI for ACS over 5 years.Independent risk factors of the need for revascularization were identified by multivariate analysis and points were assigned according to the corresponding regression coefficients.RESULTS Multivariate analysis showed that chest pain,troponin I>0.03 ng/ml,age at first PCI ≤ 6 0 years old,initial diameter stenosis at first PCI ≥90% and prior multi-vessel disease were independent risk factors requiring revascularization in patients after PCI for ACS over 5 years.Scores were assigned were respectively 5 points for chest pain,1 point for troponin I>0.03 ng/ml,1 point for the age at first PCI ≤ 60 years,2 points for initial diameter stenosis at first PCI ≥90% and 1 point for prior multi-vessel disease.The risk score was used as the test variable and the repeat revascularization was used as the state variable to draw the receiving operating characteristic(ROC) curve,and the area under the curve(AUC) value was 0.822.CONCLUSION This study presents a risk score that can be used to make a personalized pre-angiographic prediction of the need for revascularization in patients after PCI for ACS over 5 years.
作者
闫浩东
尉驰
李伟杰
李艳
宋兴隆
郭文怡
YAN Hao-dong;WEI Chi;LI Wei-jie;LI Yan;SONG Xing-long;GUO Wen-yi(Department of Cardiology,Xijing Hospital,Air Force Medical University,Xi’an 710032,Shaanxi,China)
出处
《心脏杂志》
CAS
2020年第1期24-27,共4页
Chinese Heart Journal
关键词
冠心病
血管成形术
经腔
经皮冠状动脉
冠状血管造影术
回归分析
预测
Coronary heart disease
Percutaneous coronary intervention
Coronary angiography
Regression analysis
Forcasting
