CHA<sub>2</sub>DS<sub>2</sub>-VASc评分与急性ST段抬高型心肌梗死患者介入术后无复流的相关性研究

李小杜; 何胜虎

doi:10.13201/j.issn.1001-1439.2021.03.005

CHA₂DS₂-VASc评分与急性ST段抬高型心肌梗死患者介入术后无复流的相关性研究

李小杜^1,2,
何胜虎^1, ,

- 1. 江苏省苏北人民医院心内科(江苏扬州, 225001);
- 2. 大连医科大学第二临床学院

详细信息

通讯作者: 何胜虎,E-mail:yzhshys@163.com

中图分类号: R541.4

收稿日期: 2020-09-30

Correlation between CHA₂DS₂-VASc score and no-reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

LI Xiaodu^1,2,
HE Shenghu^1, ,

- 1. Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, China;
- 2. The Second Clinical College of Dalian Medical University

More Information

Corresponding author: HE Shenghu, E-mail: yzhshys@163.com

Received Date: 30 September 2020

摘要

摘要: 目的:探讨CHA₂DS₂-VASc评分对急性ST段抬高型心肌梗死(STEMI)患者行直接经皮冠状动脉介入(PPCI)治疗后无复流发生的预测价值。方法:选择2018年1月—2020年6月因STEMI就诊于江苏省苏北人民医院心内科行PPCI治疗的患者288例,依据术后TIMI血流分为无复流组(TIMI血流≤2级)49例、复流组(TIMI血流=3级)239例。收集两组患者的一般临床资料、实验室检查指标及手术相关信息,利用CHA₂DS₂-VASc评分系统进行评分。采用Logistic单因素及多因素回归分析PPCI术后无复流发生的独立危险因素,应用ROC曲线分析CHA₂DS₂-VASc评分预测无复流发生的最佳截点。结果:无复流组的CHA₂DS₂-VASc评分显著高于复流组(3.39±1.79∶1.97±1.51,P<0.001)。多因素Logistic回归分析显示,CHA₂DS₂-VASc评分是术后无复流发生的独立预测因子(OR=1.481,95%CI:1.200~1.828,P<0.001)。ROC曲线分析发现,CHA₂DS₂-VASc评分=3分为预测无复流发生的最佳截点(AUC=0.729,95%CI:0.651~0.806),特异性为66.5%,敏感性为71.4%。结论:CHA₂DS₂-VASc评分可作为一种有效预测STEMI患者PPCI术后无复流发生的评分工具,指导临床抗栓治疗方案选择,降低术后无复流的发生。
- 无复流 /
- ST段抬高型心肌梗死 /
- 经皮冠状动脉介入治疗 /
- CHA₂DS₂-VASc评分
Abstract: Objective: To explore the value of CHA₂DS₂-VASc score in predicting no-reflow in acute ST-segment elevation myocardial infarction(STEMI) patients after primary percutaneous coronary intervention(PPCI).Methods: Two hundred and eighty-eight STEMI patients who underwent PPCI in our hospital from January 2018 to June 2020 were divided into the no-reflow group(n=49) and control group(n=239) according to their TIMI blood flow. Clinical baseline information, laboratory examination, and PPCI related information were collected and CHA₂DS₂-VASc score was used to scoring. Independent risk factors of no-reflow after PPCI were analyzed by univariate and multivariate regression analysis. The receiver operating characteristic(ROC) curve was used to analyze the cut-off point of CHA₂DS₂-VASc score in predicting no-reflow.Results: The CHA₂DS₂-VASc score was significantly higher in the no-reflow group compared to the control group(3.39±1.79 vs 1.97±1.51, P<0.001). Multivariate Logistic regression analysis showed that the CHA₂DS₂-VASc score was an independent predictor of no-reflow after PPCI(OR=1.481, 95%CI: 1.200-1.828, P<0.001). ROC analysis revealed that CHA₂DS₂-VASc score=3 was the cut-off value for predicting no-reflow(AUC=0.729, 95%CI: 0.651-0.806), with a sensitivity of 71.4% and a specificity of 66.5%.Conclusion: CHA₂DS₂-VASc score could be used as a scoring tool to predict the occurrence of no-reflow after PPCI in STEMI patients, guide the strategy of antithrombotic therapy, and reduce the incidence of no-reflow after PCI.
- no-reflow /
- ST-segment elevation myocardial infarction /
- percutaneous coronary intervention /
- CHA₂DS₂-VASc score

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