Ragab A Mahfouz, Marwa M Gad, Mohamed Arab, Moei-E Deen Abulfotouh
{"title":"st段心肌梗死患者经皮冠状动脉介入治疗后微血管功能障碍及CHA2DS2-VASc评分","authors":"Ragab A Mahfouz, Marwa M Gad, Mohamed Arab, Moei-E Deen Abulfotouh","doi":"10.1159/000520074","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the relation between CHA<sub>2</sub>DS<sub>2</sub>-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Subjects and methods: </strong>The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA<sub>2</sub>DS<sub>2</sub>-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA<sub>2</sub>DS<sub>2</sub>-VASc score.</p><p><strong>Results: </strong>Subjects were stratified into 2 groups based on IMR </≥ 40 U; 72 patients (62.6) with IMR <40 U and 43 patients (37.4) with IMR ≥40 U. Patients with IMR ≥40 U had higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score (<i>p</i> < 0.001). CHA<sub>2</sub>DS<sub>2</sub>-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA<sub>2</sub>DS<sub>2</sub>-VASc score was strongly correlated with IMR (<i>p</i> < 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA<sub>2</sub>DS<sub>2</sub>-VASc score were associated with MVD. Besides, CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients.</p><p><strong>Conclusions: </strong>The data of the current study point out that increased CHA<sub>2</sub>DS<sub>2</sub>-VASc score, lower systolic blood pressure <90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA<sub>2</sub>DS<sub>2</sub>-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.</p>","PeriodicalId":29774,"journal":{"name":"Pulse","volume":"9 3-4","pages":"125-132"},"PeriodicalIF":3.8000,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740007/pdf/pls-0009-0125.pdf","citationCount":"0","resultStr":"{\"title\":\"Presence of Microvascular Dysfunction and CHA<sub>2</sub>DS<sub>2</sub>-VASc Score in Patients with ST-Segment Myocardial Infarction after Primary Percutaneous Coronary Intervention.\",\"authors\":\"Ragab A Mahfouz, Marwa M Gad, Mohamed Arab, Moei-E Deen Abulfotouh\",\"doi\":\"10.1159/000520074\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>We aimed to investigate the relation between CHA<sub>2</sub>DS<sub>2</sub>-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Subjects and methods: </strong>The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA<sub>2</sub>DS<sub>2</sub>-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA<sub>2</sub>DS<sub>2</sub>-VASc score.</p><p><strong>Results: </strong>Subjects were stratified into 2 groups based on IMR </≥ 40 U; 72 patients (62.6) with IMR <40 U and 43 patients (37.4) with IMR ≥40 U. Patients with IMR ≥40 U had higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score (<i>p</i> < 0.001). CHA<sub>2</sub>DS<sub>2</sub>-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA<sub>2</sub>DS<sub>2</sub>-VASc score was strongly correlated with IMR (<i>p</i> < 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA<sub>2</sub>DS<sub>2</sub>-VASc score were associated with MVD. Besides, CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients.</p><p><strong>Conclusions: </strong>The data of the current study point out that increased CHA<sub>2</sub>DS<sub>2</sub>-VASc score, lower systolic blood pressure <90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA<sub>2</sub>DS<sub>2</sub>-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.</p>\",\"PeriodicalId\":29774,\"journal\":{\"name\":\"Pulse\",\"volume\":\"9 3-4\",\"pages\":\"125-132\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2021-11-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740007/pdf/pls-0009-0125.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pulse\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000520074\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/12/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pulse","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000520074","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/12/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Presence of Microvascular Dysfunction and CHA2DS2-VASc Score in Patients with ST-Segment Myocardial Infarction after Primary Percutaneous Coronary Intervention.
Objective: We aimed to investigate the relation between CHA2DS2-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI).
Subjects and methods: The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA2DS2-VASc score.
Results: Subjects were stratified into 2 groups based on IMR 2DS2-VASc score (p < 0.001). CHA2DS2-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA2DS2-VASc score was strongly correlated with IMR (p < 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA2DS2-VASc score were associated with MVD. Besides, CHA2DS2-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients.
Conclusions: The data of the current study point out that increased CHA2DS2-VASc score, lower systolic blood pressure <90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA2DS2-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.
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