Predictive Value of Lung Ultrasound Combined With ACEF Score for the Prognosis of Acute Myocardial Infarction

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-02-03 DOI:10.1002/clc.70077

Ziheng Lun, Jiexin He, Ming Fu, Shixin Yi, Haojian Dong, Ying Zhang

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引用次数: 0

Abstract

Background

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).

Hypothesis

The aim of this study is to investigate the prognostic value of LUS combined with ACEF score in AMI.

Methods

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.

Results

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.

Conclusions

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.

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肺超声联合ACEF评分对急性心肌梗死预后的预测价值

肺超声（LUS）和ACEF评分（年龄、肌酐和射血分数）已被证明是预测急性心肌梗死（AMI）不良预后的关键。本研究的目的是探讨LUS联合ACEF评分在AMI中的预后价值。方法计算LUS患者ACEF评分及8个胸椎区b线总数。在住院和随访期间记录不良事件，定义为全因死亡和其他心血管事件。多因素logistic回归确定住院期间不良事件的预测因素。多因素Cox回归确定了随访期间不良事件的预测因素。结果共纳入204例患者。b线（调整后OR为1.08,[95% CI: 1.03-1.13], p < 0.01）和ACEF评分（调整后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评分的c指数值为0.81 (p < 0.01)，两者组合的c指数值为0.86 （p < 0.01）。171例患者随访12个月（IQR, 8.13-15.93）。b线（校正HR 1.06 [95% CI: 1.03-1.09], p < 0.05）和ACEF评分（校正HR 1.95 [95% CI: 1.10-3.43], p < 0.05）仍与随访期间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评分的c指数值为0.73 (p < 0.01)，两者的综合预测能力为0.80 （p < 0.01）。结论b线和ACEF评分与AMI患者不良事件相关。当它们结合在一起时，它们在评估不良事件风险方面提供了越来越大的价值，这对风险分层具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.