中国急性心梗注册研究(CAMI)分析:预测心梗患者院内死亡风险,GRACE和TIMI评分谁更好?

2019-05-31 朱朱 中国循环杂志

中国急性心肌梗死注册登记(CAMI)研究前期分析结果表明,在预测中国急性ST段抬高型心肌梗死(STEMI)患者院内死亡风险时,TIMI和GRACE两种风险评分价值基本相当。

中国急性心肌梗死注册登记(CAMI)研究前期分析结果表明,在预测中国急性ST段抬高型心肌梗死(STEMI)患者院内死亡风险时,TIMI和GRACE两种风险评分价值基本相当。

近期,CAMI研究组最新分析结果提示,对于非ST段抬高型心肌梗死(NSTEMI)患者,这两种风险评分模型对院内死亡风险的评估价值不再一致了,GRACE评分要明显优于TIMI评分。

受试者工作特征(ROC)曲线分析显示,TIMI评分和GRACE评分对中国NSTEMI患者院内死亡率预测价值的曲线下面积分别为0.559和0.793(P<0.001)。

研究人员指出,TIMI评分源于STEMI患者溶栓研究数据库,计算起来相对便捷,但需要收集患者既往糖尿病高血压病和心绞痛病史,而既往病史往往不太可靠。

GRACE评分也并非专门针对NSTEMI患者,可用于各种类型的急性冠脉综合征,包括 STEMI和NSTEMI,而且评分所需要的某些变量在入院当时可能无法获得。

因此,还需要探索、寻找更简便、更适合预测中国急性心梗患者预后的评分体系。

研究者对CAMI研究中来自全国31个省、市和自治区107家医院的5 896例NSTEMI患者数据进行了分析。

结果显示,NSTEMI患者平均住院10天,院内死亡率为6%。68.2%为男性,平均年龄为65.4岁。

所有患者中,3.6%发生过院前心脏骤停,仅11.0%接受再灌注治疗,再灌注治疗平均时间为529.5 min,其中10.9%接受急诊经皮冠状动脉介入治疗,0.1%接受急诊冠状动脉旁路移植术。

接受他汀、β受体阻滞剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂、醛固酮受体拮抗剂治疗的患者比例分别为94.8%、71.7%、65.5%和26.0%。

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    2020-05-06 智智灵药
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    2020-02-03 whmdzju
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    2019-06-02 zhyy93

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