コミュニティにおける心筋梗塞後のリスク層分化のスコア
Mandeep Singh1, Guy S Reeder, Steven J Jacobsen
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minn 55905, USA.
Circulation
|October 31, 2002
まとめ
TIMIやPREDICTのような心筋梗塞 (MI) のリスク分層化スコアは,コミュニティの検証を必要としています. 併発症率とエジェクション分数 (EF) は,よりよいMIリスク評価のための重要な予後情報を提供します.
科学分野:
- 心臓病学 心臓病学
- 臨床リスクの階層化
- 公衆衛生は公衆衛生である.
背景:
- 既存の心筋梗塞 (MI) リスクスコアには,コミュニティの一般化能力が欠けていることが多い.
- これらのスコアと組み合わせたエジェクション分数 (EF) の予後値は十分に確立されていません.
研究 の 目的:
- 心筋梗塞における血栓溶解 (TIMI) と心疾患における死亡リスクを予測するツール (PREDICT) のスコアをコミュニティのMIコホートで評価する.
- MI後のリスク層分化のエジェクション分数 (EF) のインクリメンタル予後値を決定する.
主な方法:
- オルムステッド郡における心筋梗塞症例の検証,ECG基準 (STEMI/NSTEMI) によって層分化.
- ロジスティック回帰分析は,死亡および再発性心筋梗塞に対するTIMIおよびPREDICTスコアの差別的精度を評価するためのものです.
- スコアと併発性に対するEFのインクリメンタルバリューの評価.
主要な成果:
- 心臓病ツールの予測死亡リスク (PREDICT) スコアは,特に併発症を含むため,心筋梗塞 (TIMI) の血栓溶解のスコアと比較して,優れた差別的精度を示しました.
- 射出分数 (EF) は,既存のスコアと併発性データを超えて,重要なインクリメンタル予後情報を提供しました.
- フォローアップ後の生存率は,STセグメント上昇MI (STEMI) と非STセグメント上昇MI (NSTEMI) のコホート間で類似していました.
結論:
- 併発症率とエジェクション分数 (EF) は,コミュニティベースのMIリスクの階層化における重要な予後指標である.
- MIのリスク分層モデルは,より高い正確性のために共病率とEFの両方を組み込む必要があります.
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