非st段抬高型心肌梗死的风险分层:评估印度人群中各种风险评分的预测准确性。

IF 0.8 Q4 RESPIRATORY SYSTEM
Ruchi Sharma, Bhushan Shah, Sumit Verma, Vijay Pathak, Sunil Sharma, Pradeep Meena, Shekhar Kunal
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引用次数: 0

摘要

风险分层对非st段抬高型心肌梗死(NSTEMI)患者的管理至关重要。虽然存在多种风险评分,但它们在印度等发展中国家的有效性仍然有限。本研究比较了PURSUIT、HEART、TIMI、GRACE 2.0和CAMI-NSTEMI评分对NSTEMI患者主要不良心血管事件(MACE)的预测准确性,包括死亡、非致死性心肌梗死、紧急经皮冠状动脉介入治疗和冠状动脉旁路移植术。这是一项单中心前瞻性观察性研究,其中诊断为NSTEMI的患者入组。记录详细的临床病史,包括症状和危险因素。计算5个风险评分(TIMI、GRACE 2.0、PURSUIT、HEART和CAMI-NSTEMI评分)。评估住院、14天、6个月和1年MACE的结果。共纳入1102例患者,平均年龄59.6±11.2岁。140例患者(12.7%)发生MACE, 89例死亡(8.1%)。MACE患者年龄较大,吸烟或患有高血压、糖尿病或中风的可能性较大。多因素logistic回归分析发现,过去48小时内心绞痛、糖尿病、吸烟、心脏骤停和心电图QRS碎片化是独立的MACE预测因素。TIMI对院内MACE的预测能力最高,而GRACE在14天、6个月和1年的预后方面表现出色。所有风险评分都能有效预测短期和中期MACE, GRACE对长期预测效果最好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population.

Risk stratification is essential in managing patients with non-ST-elevation myocardial infarction (NSTEMI). While multiple risk scores exist, their validation in developing countries like India remains limited. This study compares the predictive accuracy of the PURSUIT, HEART, TIMI, GRACE 2.0, and CAMI-NSTEMI scores for major adverse cardiovascular events (MACE), including death, non-fatal myocardial infarction, emergency percutaneous coronary intervention, and coronary artery bypass grafting, in NSTEMI patients. This was a single-center prospective observational study wherein patients diagnosed with NSTEMI were enrolled. Detailed clinical histories, including symptomatology and risk factors, were recorded. Five risk scores (TIMI, GRACE 2.0, PURSUIT, HEART, and CAMI-NSTEMI scores) were computed. Outcomes were assessed for in-hospital, 14-day, six-month, and one-year MACE. A total of 1102 patients were enrolled, with a mean age of 59.6±11.2 years. MACE occurred in 140 patients (12.7%), with 89 deaths (8.1%). Patients with MACE were older and more likely to smoke or have hypertension, diabetes, or stroke. Multivariate logistic regression analysis identified angina in the last 48 hours, diabetes, smoking, cardiac arrest, and fragmented QRS on electrocardiogram as independent MACE predictors. TIMI showed the highest predictive ability for in-hospital MACE, while GRACE excelled for 14-day, 6-month, and 1-year outcomes. All risk scores effectively predicted short- and intermediate-term MACE, with GRACE performing best for longer-term predictions.

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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
1
审稿时长
12 weeks
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