TIMI危险评分对ST段抬高型冠状动脉非阻塞性心肌梗死患者远期预后的预测价值  

Prognostic Value of TIMI Risk Scores in Patients With ST-elevation Myocardial Infarction With Nonobstructive Coronary Arteries

作　　者：黄思壮 高斯德 林徐泽 俞梦越[1] HUANG Sizhuang;GAO Side;LIN Xuze;YU Mengyue(Premium Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院特需医疗中心,北京市100037

出　　处：《中国循环杂志》2022年第11期1091-1096,共6页Chinese Circulation Journal

基　　金：国家自然科学基金项目(81670415)。

摘　　要：目的:探究TIMI危险评分对ST段抬高型冠状动脉(冠脉)非阻塞性心肌梗死(MINOCA)患者远期预后的预测价值。方法:回顾性纳入2015年1月至2019年12月在中国医学科学院阜外医院行冠脉造影并诊断为ST段抬高型MINOCA患者461例,根据患者TIMI危险评分分为低危组(≤3分,n=157)和中高危组(>3分,n=304),收集患者临床数据并进行随访(中位随访时间41.7个月),分析两组患者临床特征及随访时间内主要不良心血管事件(MACE)发生情况,并进行Cox回归分析评估MACE的影响因素,绘制Kaplan-Meier曲线及ROC曲线。结果:低危组和中高危组患者的MACE发生率分别为8.9%和18.1%,差异有统计学意义(P<0.05)。Cox回归分析显示,低危组与较低的MACE风险独立相关(HR=0.468,95%CI:0.258~0.849,P=0.013)。ROC曲线分析提示TIMI危险评分对ST段抬高型MINOCA患者具有一定的预后预测价值(AUC为0.679)。结论:TIMI危险评分对ST段抬高型MINOCA患者远期预后具有潜在预测价值。Objectives:To investigate the predictive value of TIMI risk scores for long-term prognosis of patients with ST-elevation myocardial infarction with non-obstructive coronary arteries(MINOCA).Methods:A total of 461 patients diagnosed with ST-elevation MINOCA who underwent coronary angiography in Fuwai Hospital from January 2015 to December 2019 were enrolled.Patients were divided into low-risk group(≤3,n=157)and intermediate-high risk group(>3,n=304)according to TIMI risk scores.The clinical characteristics and outcomes of the patients were assessed.Cox regression analysis,Kaplan-Meier and ROC curve analysis were performed.Results:The incidence of total major adverse cardiovascular events(MACE)was significantly higher in patients with intermediate-high TIMI risk scores than in patients with low TIMI risk scores(18.1%vs.8.9%,P=0.004)during the median follow-up of 41.7 months.Cox regression analysis showed that low-risk group was independently associated with lower risk of MACE(HR=0.468,95%CI:0.258-0.849,P=0.013).The AUC was 0.679,suggesting that the TIMI risk score is a useful predictor of long-term MACE among ST-segment elevation MINOCA patients.Conclusions:TIMI risk score serves as a useful predictor of long-term prognosis of patients with ST-segment elevation MINOCA.

关 键 词：冠状动脉非阻塞性心肌梗死 TIMI危险评分 危险因素 ST段抬高型心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]