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An R-Based Landscape Validation of a Competing Risk Model
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在MINOCA中预测评分系统的性能:GRACE,TIMI,HEART和ACEF分数之间的比较
Damiano Fedele1,2, Lisa Canton1,2, Francesca Bodega1,2
1Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy.
Journal of clinical medicine
|September 9, 2023
概括
像GRACE这样的预后得分显示,对于非阻塞性冠状动脉 (MINOCA) 患者的心肌梗塞的患者,表现不佳. 虽然GRACE最好地预测了全因死亡,但需要新的MINOCA特定工具.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 健康结果的健康结果.
背景情况:
- 带有非阻塞性冠状动脉 (MINOCA) 的心肌梗塞具有显著的预后.
- 现有的预后评分系统需要对MINOCA患者群体进行验证.
研究的目的:
- 在MINOCA患者中评估和比较GRACE,TIMI,HEART和ACEF得分的预后性能.
- 评估这些分数对主要不良心血管事件和一年内全因死亡的预测准确度.
主要方法:
- 250名MINOCA患者的回顾性分析 (2017年1月至2021年9月).
- 在入学时计算GRACE,TIMI,HEART和ACEF分数.
- 主要结局:综合所有死因和急性心肌梗塞 (AMI) 在1年的随访.
主要成果:
- 测试得分显示,在预测MINOCA.中复合主要不良事件时,表现不佳 (AUC为0.7-0.8).
- 格雷斯得分证明了所有死因的最佳预测,具有很高的特异性.
- GRACE (AUC=0.932) 和ACEF (AUC=0.828) 评分显示,对预测1年全因死亡的高准确性.
结论:
- 目前在阻塞性AMI队列中验证的预后工具可能在MINOCA中提供实用性,但不够理想.
- 开发专门为MINOCA患者量身定制的风险评估工具至关重要.
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