经皮冠状动脉介入治疗相关心肌梗死的危险因素和预测模型的建立  

Risk Factors and Prediction Model for Percutaneous Coronary Intervention Related Myocardial Infarction

作　　者：周沛 赵宇彤 巩师毅 刘增义 陈茜 万朵 刘健[1] ZHOU Pei;ZHAO Yutong;GONG Shiyi;LIU Zengyi;CHEN Xi;WAN Duo;LIU Jian(Department of Cardiology,Peking University Pecple's Hospital,Beijing(100044),China)

机构地区：[1]北京大学人民医院急性心肌梗死早期预警和干预北京市重点实验室心内科,北京市100044 [2]北京大学第三医院心内科 [3]北京大学基础医学院 [4]北京大学第三医院

出　　处：《中国循环杂志》2020年第5期450-454,共5页Chinese Circulation Journal

基　　金：首都特色临床医学应用发展项目(Z171100001017099)。

摘　　要：目的:筛选经皮冠状动脉介入治疗(PCI)相关心肌梗死(PMI)的危险因素,建立PMI发生风险的危险模型。方法:回顾性分析了北京大学人民医院801例择期PCI患者的临床基线特征、冠状动脉造影检查结果及PCI操作资料,并就此根据临床实际情况分为PMI组(n=113)和无PMI组(n=688)。同时利用多元Logistic回归分析筛选PMI的独立危险因素并建立危险模型。结果:PMI发生率为14.1%(113/801),经过多元Logistic回归分析发现PMI的独立危险因素包括年龄(OR=1.040,95%CI:1.015~1.065,P=0.001),多支病变(OR=1.740,95%CI:1.028~2.945,P=0.039),支架数目(OR=1.787,95%CI:1.404~2.275,P=0.000),旋磨(OR=4.046,95%CI:1.336~12.252,P=0.013),并建立了危险模型。该模型的ROC曲线下面积为0.706(95%CI:0.657~0.754)。结论:年龄、多支病变、支架数目及旋磨均为PMI发生的独立危险因素,由此建立的危险模型能够较好地指导临床工作者评估PMI风险。Objectives:To investigate the independent risk factors of percutaneous coronary intervention(PCI)related myocardial infarction(PMI),and develop a risk model of PMI based on defined risk factors.Methods:801 patients undergoing elective PCI were included in this single-center retrospective analysis.Clinical characteristics,coronary angiography findings and PCI procedural factors were collected.Multivariate logistic regression analysis was performed to define the independent risk factors of PMI,and then establish a risk model of PMI.Results:PMI occurred in 113(14.1%)out of 801 patients.Multivariate logistic regression analysis showed that age(OR=1.040,95%CI:1.015-1.065,P=0.001),multivessel lesion(OR=1.740,95%CI:1.028-2.945,P=0.039),number of stent(OR=1.787,95%CI:1.404-2.275,P<0.001),and rotational atherectomy(OR=4.046,95%CI:1.336-12.252,P=0.013)were the independent risk factors of PMI.The area under the received operating characteristic curve of the developed risk model of PMI was 0.706(95%CI:0.657-0.754).Conclusions:Age,multivessel lesion,number of stent,and rotational atherectomy are independent risk factors of PMI.The risk model could help identify patients at high risk of PMI after PCI.

关 键 词：经皮冠状动脉介入治疗 心肌梗死 危险因素 危险模型 

分 类 号：R541[医药卫生—心血管疾病]