Georgios Chalikias, Dimitrios Stakos, Anna Dagre, Georgios Triantis, George Kassimis, Ioannis Tsiafoutis, Juan Carlos Kaski, Dimitrios Tziakas
{"title":"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。","authors":"Georgios Chalikias, Dimitrios Stakos, Anna Dagre, Georgios Triantis, George Kassimis, Ioannis Tsiafoutis, Juan Carlos Kaski, Dimitrios Tziakas","doi":"10.1097/MCA.0000000000001563","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The SAVE score adequately identified patients with high angiographic risk who may benefit from early invasive management strategies.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A novel algorithm to identify high risk non-ST-elevation acute coronary syndrome patients.\",\"authors\":\"Georgios Chalikias, Dimitrios Stakos, Anna Dagre, Georgios Triantis, George Kassimis, Ioannis Tsiafoutis, Juan Carlos Kaski, Dimitrios Tziakas\",\"doi\":\"10.1097/MCA.0000000000001563\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The SAVE score adequately identified patients with high angiographic risk who may benefit from early invasive management strategies.</p>\",\"PeriodicalId\":10702,\"journal\":{\"name\":\"Coronary artery disease\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Coronary artery disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MCA.0000000000001563\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Coronary artery disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCA.0000000000001563","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
A novel algorithm to identify high risk non-ST-elevation acute coronary syndrome patients.
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.
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.
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