A novel algorithm to identify high risk non-ST-elevation acute coronary syndrome patients.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2025-08-12 DOI:10.1097/MCA.0000000000001563

Georgios Chalikias, Dimitrios Stakos, Anna Dagre, Georgios Triantis, George Kassimis, Ioannis Tsiafoutis, Juan Carlos Kaski, Dimitrios Tziakas

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引用次数: 0

Abstract

Background: Timing of invasive coronary angiography in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains controversial. Angiographic risk and, hence, myocardium at risk are not necessarily considered in currently used non-ST elevation myocardial infarction management algorithms. The aim of this study was to assess the diagnostic performance of the SAVE score in NSTE-ACS patients to noninvasively identify patients with high-risk angiographic risk who might benefit from an early invasive strategy.

Methods: We prospectively assessed 950 consecutive patients admitted to five different hospitals with a diagnosis of NSTE-ACS, 598 (491 male, mean age 63 ± 12 years) of whom were risk-stratified according to the SAVE risk score. The primary endpoint was the identification of high-risk angiographic features.

Results: High-risk angiographic features were observed in 347 (58%) (292 male/55 female). SAVE score was significantly higher in patients in the high-risk angiography group compared with patients without high-risk features [6 (4.5-8) ± vs. 4 (2-5.5); P < 0.001]. Using the proposed risk score, 79% (275 out of 347 patients) were correctly identified as having a high angiographic risk, and 58% (145 out of 251 patients with low-risk angiographic features) were also correctly identified by the SAVE score.

Conclusions: The SAVE score adequately identified patients with high angiographic risk who may benefit from early invasive management strategies.

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一种识别高风险非st段抬高急性冠状动脉综合征患者的新算法。

背景：非st段抬高急性冠脉综合征（NSTE-ACS）患者有创冠状动脉造影的时机仍有争议。血管造影风险，因此，在目前使用的非st段抬高心肌梗死管理算法中，不一定要考虑有风险的心肌。本研究的目的是评估SAVE评分在非侵入性NSTE-ACS患者中的诊断性能，以识别可能从早期侵入策略中获益的高危血管造影风险患者。方法：前瞻性评估5家不同医院连续收治的950例诊断为NSTE-ACS的患者，其中598例（491例男性，平均年龄63±12岁）根据SAVE风险评分进行风险分层。主要终点是确定高危血管造影特征。结果：347例（58%）存在高危血管造影特征（男性292例/女性55例）。高危血管造影组患者的SAVE评分明显高于无高危特征的患者[6（4.5-8）±4 (2-5.5)]；结论：SAVE评分可以充分识别血管造影高风险患者，这些患者可能受益于早期侵入性治疗策略。

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

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.