Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-02-26 DOI:10.1111/anec.70056

Jiayan Xin, Yingwu Liu, Meng Ning, Chong Zhang

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Abstract

Objective

To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.

Methods

STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.

Results

Patients were divided into MACE group (N = 69) and non-MACE group (N = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.

Conclusion

Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.

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无创心功能监测联合GRACE评分对st段抬高型心肌梗死患者短期预后的预测价值

目的探讨STEMI患者无创心功能监测指标与近期不良预后的相关性。选择具有较高诊断价值的血流动力学指标，结合GRACE评分构建新的风险预测模型，并对新预测模型的有效性进行评价。方法选择符合纳入标准和排除标准的STEMI患者。所有患者随访6个月的主要不良心血管事件（MACE）。采用单因素和多因素logistic回归分析无创心功能监测指标。采用ROC曲线评价无创心功能指标预测MACE的准确性。然后，建立了新的风险预测模型，并用ROC曲线评价其预测效率。结果将患者分为MACE组（N = 69）和非MACE组（N = 173），发现卒中容量（SV）、心输出量（CO）、心脏指数（CI）、心脏时间间隔（CTI）、早期舒张充盈率（EDFR）、舒张末期容积（EDV）和全身血管阻力（SVR）是STEMI患者近期MACE事件的重要预测因子。多因素logistic回归分析证实无创心功能指标为独立预测因子。此外，SV和CTI与GRACE评分的结合有可能提高MACE的预测精度。结论无创血流动力学指标SV、CO、CI、CTI、EDFR、EDV、SVR不仅可以独立预测STEMI患者近期MACE的发生风险，而且可以作为GRACE评分的联合指标，显著提高GRACE评分的预测能力。

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

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.