非st段抬高急性冠状动脉综合征患者心肌梗死溶栓(TIMI)风险评分与冠状动脉疾病血管造影严重程度的关系

University Heart Journal Pub Date : 2019-08-18 DOI:10.3329/UHJ.V15I2.42649

A. Bashiruddin, M. Chowdhury, B. Bhattacharjee, Abul Hossen Shahin, S. Ahsan, Mrm Mandal, S. Dhar, I. Mahmud, S. Hossain

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引用次数: 0

摘要

背景:临床指南建议急性冠脉综合征(ACS)的最佳管理应包括患者风险分层。预测冠状动脉疾病(CAD)的解剖扩展也可能对临床决策有用。目的:我们研究的目的是确定TIMI风险评分是否与NSTE- ACS患者冠心病的血管造影程度和严重程度相关。材料与方法:本研究是一项横断面观察性研究，于2017年9月至2018年5月在Chattogram Medical College Hospital (CMCH)心内科开展。采用目的抽样方法，选取200例诊断为NSTE-急性冠脉综合征的患者作为样本。计算每位患者的TIMI风险评分，并根据患者的TIMI风险评分将患者分为3组:低危(0-2);中度风险(3-4);高风险(5-7)。采用Vessel评分和Gensini评分评估冠心病的严重程度。结果:研究人群年龄均值±SD为53.7±10.8岁(37 ~ 77岁)，男性142例(71%)。在心血管危险因素方面，糖尿病患者137例(68.5%)，血脂异常患者83例(41.5%)，高血压患者155例(77.5%)，吸烟者136例(68%)，冠心病家族史患者70例(35%)。与TIMI风险评分为3-4分(17.9%)和TIMI风险评分< 3分(2%)的患者(p< 0.001)相比，高风险TIMI组患者Gensini评分更高(p = 4)，更有可能出现显著的三支血管CAD(65.9%)。结论:研究显示TIMI评分与Gensini评分评价的CAD程度有显著相关。预测NSTE-ACS患者严重CAD的准确性较高。《大学心脏杂志》2019年7月第15卷第2期;68 - 73

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Association of Thrombolysis in Myocardial Infarction (TIMI) Risk Score with Angiographic Severity of Coronary Artery Disease In Patients with Non-ST Elevation Acute Coronary Syndrome

Background: Clinical guidelines recommend that optimal management of acute coronary syndrome (ACS) should include patient risk stratification. Predicting the anatomical extension of coronary artery disease (CAD) is also potentially useful for clinical decision. Objective: The objective of our study was to determine whether the TIMI risk score correlates with the angiographic extent and severity of CAD in patients with NSTE- ACS. Materials and Methods: This was a cross-sectional observational study carried out in the Department of Cardiology, Chattogram Medical College Hospital (CMCH) from September 2017 to May 2018. A total of 200 patients diagnosed with NSTE- Acute Coronary Syndrome were included as sample by purposive sampling method. TIMI risk score for each patient was calculated and the patients were stratified into 3 groups according to the TIMI risk score: low risk (0-2); intermediate risk (3-4); high risk (5-7). The severity of the CAD was assessed by Vessel score and Gensini score. Result: The mean ± SD of the age of study population was 53.7 ±10.8 years (range 37–77) and 142 (71%) were male. Regarding cardiovascular risk factors, 137 (68.5%) patients had diabetes mellitus, 83 (41.5%) had dyslipidaemia, 155 (77.5%) had hypertension, 136 (68%) were current smoker and 70 (35%) had a family history of CAD. The Gensini score was higher in patients at high risk TIMI group (p<0.001). Moreover, there was a signiûcant positive correlation between the TIMI and Gensini score (r=0.446,p<0.001). TIMI score can predict significant CAD moderately well (area under the curve 0.661, p=0.001). Patients with TIMI score > 4 were more likely to have significant three vessel CAD (65.9%) versus those with TIMI risk score 3-4 (17.9%) and TIMI risk score < 3 (2%) (p< 0.001). Conclusion: Study showed the TIMI score is significantly correlated with the extent of CAD as assessed by the Gensini score. It is accurate for predicting severe CAD among NSTE-ACS patients. University Heart Journal Vol. 15, No. 2, Jul 2019; 68-73

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University Heart Journal

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