摘要
目的:分析mC2HEST评分与急性心肌梗死(acutemyocardialinfarction,AMI)患者急诊经皮冠状动脉介入治疗(percutaneouscoronaryintervention,PCI)后住院期间预后的关系。方法:收集2020-01-01—2021-12-31在云南大学附属医院心内科住院诊断为AMI并于发病24h内行急诊PCI术且术前无心房颤动(房颤)的患者,共352例。收集基线资料和院内终点事件(全因死亡、新发房颤、心源性休克、心脏骤停、缺血性卒中、出血),计算mC2HEST评分。比较mC2HEST评分各分数患者的预后事件发生率。使用logistic回归分析探讨mC2HEST评分与预后事件的关系。绘制ROC曲线评估mC2HEST评分预测预后事件的能力。根据mC2HEST评分,将患者分为低危组(1~2分)、中危组(3~4分)和高危组(≥5分),绘制3组患者院内全因死亡的Kaplan-Meier曲线,分析3组患者院内全因死亡的风险差异。结果:全因死亡、新发房颤、心源性休克、出血事件的发生率随着mC2HEST评分的增加而升高。mC2HEST评分是全因死亡(OR=3.993)、新发房颤(OR=3.025)、心源性休克(OR=1.375)、出血(OR=1.334)的独立危险因素。mC2HEST评分对全因死亡(AUC=0.925)、新发房颤(AUC=0.832)具有良好的预测价值,对心源性休克(AUC=0.700)和出血(AUC=0.678)也有一定预测价值。Kaplan-Meier生存曲线提示mC2HEST评分高危组的院内死亡累积风险较中危组、低危组显著升高(P<0.05)。结论:mC2HEST评分是AMI患者急诊PCI术后住院期间全因死亡、新发房颤、心源性休克、出血的独立危险因素;相较于低危、中危患者,mC2HEST评分高危(≥5分)患者的院内全因死亡风险显著增加。但mC2HEST评分未表现出与心脏骤停和卒中的相关性。
Objective:To analyze the relationship between mC2HEST score and hospitalization outcomes in patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI).Methods:Three hundred and fifty-two patients diagnosed with AMI in the Department of Cardiology at Affiliated Hospital of Yunnan University from January 1,2020 to December 31,2021 were enrolled.All patients underwent emergency PCI within 24 hours of onset and without preoperative atrial fibrillation.The baseline data and hospital endpoint events,including all-cause death,new-onset atrial fibrillation,cardiogenic shock,cardiac arrest,ischemic stroke,and bleeding,were collected,and the mC2HEST scores were calculated.The incidence of prognostic events among patients with different mC2HEST scores was compared.The logistic regression analysis was used to explore the relationship between mC2HEST score and prognostic events.The ROC curve was drawn to evaluate the ability of the mC2HEST score,and the Kaplan-Meier survival curve was drawn to evaluate the in-hospital allcause death.Lastly,we analyzed the differences in the risk of in-hospital all-cause death.Results:The incidence of all-cause death,new-onset atrial fibrillation,cardiogenic shock,and bleeding events increased with the increase of the mC2HEST score.The mC2HEST score was an independent risk factor for all-cause death(OR=3.993),new-Onset atrial fibrillation(OR=3.025),cardiogenic shock(OR=1.375).and bleeding(OR=1.334).The mC2HEST score had good predictive value for all-cause death(AUC=0.925)and new-onset atrial fibrillation(AUC=0.832),as well as for cardiogenic shock(AUC=0.700)and bleeding(AUC=0.678).The Kaplan-Meier survival curve suggested that the cumulative risk of in-hospital death in the mC2HEST score high-risk group was significantly higher compared with the intermediate-risk and low-risk groups(P<o.05).Conclusion:The mC2HEST score is an independent risk factor for all-cause death,new-onset atrial fibrillation,cardiogenic shock,and bleeding during hospitalization
作者
杨蓓
彭秋菊
YANG Bei;PENG Qiuju(Department of Cardiology,Affiliated Hospital of Yunnan University,Kunming,65o021,China;Graduate School of Kunming Medical University)
出处
《临床心血管病杂志》
CAS
2024年第5期377-382,共6页
Journal of Clinical Cardiology
