Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in
Jiayan Xin1,2,3,4, Yingwu Liu2,3,4,5, Meng Ning2,3,4,5
1The Third Central Clinical College of Tianjin Medical University, Tianjin, China.
Insights
Non-invasive cardiac function indexes like stroke volume and cardiac time intervals can predict major adverse cardiovascular events in STEMI patients. Combining these with GRACE scores improves risk prediction for better patient outcomes.
Area of Science:
- Cardiology
- Medical Technology
- Predictive Analytics
Background:
- ST-elevation myocardial infarction (STEMI) poses significant risks for major adverse cardiovascular events (MACE).
- Accurate risk stratification is crucial for managing STEMI patients and improving prognosis.
- Current risk models may benefit from incorporating novel, non-invasive monitoring data.
Purpose of the Study:
- To explore the relationship between non-invasive cardiac function monitoring indexes and recent MACE in STEMI patients.
- To develop and evaluate a novel risk prediction model by integrating key hemodynamic indexes with the existing GRACE score.
Main Methods:
- A cohort of STEMI patients was followed for 6-month MACE.
- Non-invasive cardiac function indexes were analyzed using univariate and multivariate logistic regression.
- Receiver Operating Characteristic (ROC) curves assessed prediction accuracy; a new model was built and validated.
Main Results:
- Stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were significant MACE predictors.
- Non-invasive indicators were confirmed as independent predictors in multivariate analysis.
- Combining SV and CTI with the GRACE score showed enhanced MACE prediction accuracy.
Conclusions:
- Non-invasive hemodynamic indicators (SV, CO, CI, CTI, EDFR, EDV, SVR) independently predict recent MACE in STEMI.
- These indexes, when combined, significantly enhance the predictive power of the GRACE score for MACE risk stratification.
Objective:
To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.
Methods:
STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.
Results:
Patients were divided into MACE group (N = 69) and non-MACE group (N = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.
Conclusion:
Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.
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