M. Mokarrab, A. Ismail, M. Mostafa, Abdelrahman Elgendy, H. Sabry, A. Yousry
{"title":"不同风险评分对初步经皮冠状动脉介入治疗后造影剂肾病和短期预后预测价值的比较研究","authors":"M. Mokarrab, A. Ismail, M. Mostafa, Abdelrahman Elgendy, H. Sabry, A. Yousry","doi":"10.4172/2155-9880.1000535","DOIUrl":null,"url":null,"abstract":"Background: Meticulous risk stratification for contrast-induced nephropathy (CIN) is important for patients with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PPCI). \nAim of the work: To compare between different risk scores for predicting contrast-induced nephropathy (CIN) and short outcome after primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction. \nMaterials and methods: We prospectively enrolled 100 patients who presented with STEMI and treated with Primary PCI. Mehran, Gao, Chen, ACEF or AGEF (age, serum creatinine, or glomerular filtration rate, and ejection fraction); and GRACE (Global Registry for Acute Coronary Events) risk scores were calculated for each patient. The predictive accuracy of the 6 scores for CIN, in-hospital death and major adverse clinical events (MACEs) were assessed by Receiver operating characteristics (ROC) curve. CIN was defined as an absolute increase of serum creatinine by ≥ 0.5 mg/dl or a relative increase of serum creatinine by ≥ 25% from baseline value, at 48-72 h following the exposure to contrast media (CM). The data was analyzed using Chi-square test using SPSS (Statistical package for social science) software. \nResults: All risk scores had relatively good predictive accuracy for CIN (Area under the curve (AUC) ranged from 0.671 to 0.829) and performed well for prediction of in-hospital death (AUC ranged from 0.838 to 0.973) and MACEs (AUC ranged from 0.815 to 0.926). The Mehran and Gao risk scores had better predictive accuracy for CIN. While Mehran and GRACE risk scores had better predictive accuracy for in-hospital death and MACEs. \nConclusion: Risk scores for predicting CIN perform well in stratifying the risk of CIN, in-hospital death and MACEs in patients with STEMI undergoing PPCI. The Gao, Mehran risk scores appear to have greater predictive value for CIN. While GRACE and Mehran scores had highest predictive accuracy for in hospital death and MACEs than the other risk scores.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"11 1","pages":"1-11"},"PeriodicalIF":0.0000,"publicationDate":"2017-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Study of Predictive Value for Different Risk Scores forPredicting Contrast Induced Nephropathy and Short Outcome afterPrimary Percutaneous Coronary Intervention\",\"authors\":\"M. Mokarrab, A. Ismail, M. Mostafa, Abdelrahman Elgendy, H. Sabry, A. Yousry\",\"doi\":\"10.4172/2155-9880.1000535\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Meticulous risk stratification for contrast-induced nephropathy (CIN) is important for patients with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PPCI). \\nAim of the work: To compare between different risk scores for predicting contrast-induced nephropathy (CIN) and short outcome after primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction. \\nMaterials and methods: We prospectively enrolled 100 patients who presented with STEMI and treated with Primary PCI. Mehran, Gao, Chen, ACEF or AGEF (age, serum creatinine, or glomerular filtration rate, and ejection fraction); and GRACE (Global Registry for Acute Coronary Events) risk scores were calculated for each patient. The predictive accuracy of the 6 scores for CIN, in-hospital death and major adverse clinical events (MACEs) were assessed by Receiver operating characteristics (ROC) curve. CIN was defined as an absolute increase of serum creatinine by ≥ 0.5 mg/dl or a relative increase of serum creatinine by ≥ 25% from baseline value, at 48-72 h following the exposure to contrast media (CM). The data was analyzed using Chi-square test using SPSS (Statistical package for social science) software. \\nResults: All risk scores had relatively good predictive accuracy for CIN (Area under the curve (AUC) ranged from 0.671 to 0.829) and performed well for prediction of in-hospital death (AUC ranged from 0.838 to 0.973) and MACEs (AUC ranged from 0.815 to 0.926). The Mehran and Gao risk scores had better predictive accuracy for CIN. While Mehran and GRACE risk scores had better predictive accuracy for in-hospital death and MACEs. \\nConclusion: Risk scores for predicting CIN perform well in stratifying the risk of CIN, in-hospital death and MACEs in patients with STEMI undergoing PPCI. The Gao, Mehran risk scores appear to have greater predictive value for CIN. While GRACE and Mehran scores had highest predictive accuracy for in hospital death and MACEs than the other risk scores.\",\"PeriodicalId\":15504,\"journal\":{\"name\":\"Journal of Clinical and Experimental Cardiology\",\"volume\":\"11 1\",\"pages\":\"1-11\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical and Experimental Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4172/2155-9880.1000535\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical and Experimental Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4172/2155-9880.1000535","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:对于st段抬高型心肌梗死(STEMI)并接受原发性经皮冠状动脉介入治疗(PPCI)的患者,对造影剂肾病(CIN)进行细致的风险分层是很重要的。研究目的:比较不同风险评分对ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后造影剂肾病(CIN)和短期预后的预测价值。材料和方法:我们前瞻性地招募了100例STEMI患者并接受了初级PCI治疗。Mehran, Gao, Chen, ACEF或AGEF(年龄,血清肌酐,或肾小球滤过率,射血分数);计算每位患者的GRACE(全球急性冠状动脉事件登记)风险评分。采用受试者工作特征(ROC)曲线评估6项评分对CIN、院内死亡和主要临床不良事件(mace)的预测准确性。CIN定义为暴露于造影剂(CM)后48-72小时,血清肌酐绝对升高≥0.5 mg/dl或血清肌酐相对升高≥25%。采用SPSS (Statistical package for social science)软件对数据进行卡方检验。结果:各风险评分对CIN(曲线下面积(Area under curve, AUC)为0.671 ~ 0.829)有较好的预测准确度,对院内死亡(AUC为0.838 ~ 0.973)和mace (AUC为0.815 ~ 0.926)有较好的预测准确度。Mehran和Gao风险评分对CIN有更好的预测准确性。而Mehran和GRACE风险评分对院内死亡和mace有更好的预测准确性。结论:预测CIN的风险评分对STEMI患者行PPCI的CIN、院内死亡和mace的风险有较好的分层效果。Gao、Mehran风险评分似乎对CIN有更大的预测价值。而GRACE和Mehran评分对院内死亡和mace的预测准确性高于其他风险评分。
Comparative Study of Predictive Value for Different Risk Scores forPredicting Contrast Induced Nephropathy and Short Outcome afterPrimary Percutaneous Coronary Intervention
Background: Meticulous risk stratification for contrast-induced nephropathy (CIN) is important for patients with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PPCI).
Aim of the work: To compare between different risk scores for predicting contrast-induced nephropathy (CIN) and short outcome after primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction.
Materials and methods: We prospectively enrolled 100 patients who presented with STEMI and treated with Primary PCI. Mehran, Gao, Chen, ACEF or AGEF (age, serum creatinine, or glomerular filtration rate, and ejection fraction); and GRACE (Global Registry for Acute Coronary Events) risk scores were calculated for each patient. The predictive accuracy of the 6 scores for CIN, in-hospital death and major adverse clinical events (MACEs) were assessed by Receiver operating characteristics (ROC) curve. CIN was defined as an absolute increase of serum creatinine by ≥ 0.5 mg/dl or a relative increase of serum creatinine by ≥ 25% from baseline value, at 48-72 h following the exposure to contrast media (CM). The data was analyzed using Chi-square test using SPSS (Statistical package for social science) software.
Results: All risk scores had relatively good predictive accuracy for CIN (Area under the curve (AUC) ranged from 0.671 to 0.829) and performed well for prediction of in-hospital death (AUC ranged from 0.838 to 0.973) and MACEs (AUC ranged from 0.815 to 0.926). The Mehran and Gao risk scores had better predictive accuracy for CIN. While Mehran and GRACE risk scores had better predictive accuracy for in-hospital death and MACEs.
Conclusion: Risk scores for predicting CIN perform well in stratifying the risk of CIN, in-hospital death and MACEs in patients with STEMI undergoing PPCI. The Gao, Mehran risk scores appear to have greater predictive value for CIN. While GRACE and Mehran scores had highest predictive accuracy for in hospital death and MACEs than the other risk scores.