社区中心肌梗塞后风险分层的得分
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
概括
心肌梗塞 (MI) 的风险分层得分,如TIMI和PREDICT,需要社区验证. 同病症和射出分数 (EF) 为更好的心脏病发作风险评估提供了关键的预后信息.
科学领域:
- 心脏病学 心脏病学
- 临床风险分层的临床风险分层
- 公共卫生 公共卫生
背景情况:
- 现有的心肌梗塞 (MI) 风险得分往往缺乏社区概括性.
- 与这些分数相结合的喷射分数 (EF) 的预后值尚未得到充分确立.
研究的目的:
- 评估心肌梗塞中血栓溶解 (TIMI) 和预测心脏病死亡风险工具 (PREDICT) 在社区MI队列中的得分.
- 为了确定MI后风险分层的喷射分数 (EF) 的增量预后值.
主要方法:
- 根据心电图标准 (STEMI/NSTEMI) 分层对奥尔姆斯特德县心脏病发作的验证.
- 后勤回归分析用于评估TIMI和PREDICT分数对死亡和复发性MI的分辨准确性.
- 评估EF的增量值,比得分和并发症.
主要成果:
- 心脏病工具 (PREDICT) 预测死亡风险得分显示,与心肌梗塞 (TIMI) 血栓溶解得分相比,分辨准确度更高,特别是因为它包含了并发症.
- 射出分数 (EF) 提供了超出现有得分和并发症数据的显著增量预后信息.
- 在随访后,ST段升高MI (STEMI) 和非ST段升高MI (NSTEMI) 队列之间的生存率相似.
结论:
- 伴发病率和射出分数 (EF) 是基于社区的MI风险分层的重要预后指标.
- 肌痛性心脏病的风险分层模型应该包括并发症和EF,以提高准确性.
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