冠状动脉斑块负荷对老年急性心肌梗死患者介入术后再发心肌梗死的预测价值  

Predictive value of coronary plaque burden for recurrent myocardial infarction after PCI in elderly patients with AMI

作　　者：李志萍 吕岩[2] Li Zhiping;Lu Yan(Department of Intervention,First Hospital of China Medical University,Shenyang 110001,Liaoning Province China)

机构地区：[1]中国医科大学附属第一医院介入科,沈阳110001 [2]中国医科大学附属第一医院心内科,沈阳110001

出　　处：《中华老年心脑血管病杂志》2023年第12期1273-1276,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81670320)。

摘　　要：目的探讨冠状动脉斑块负荷对老年急性心肌梗死患者PCI术后再发心肌梗死的预测价值。方法回顾性收集2019年1月至2021年12月中国医科大学附属第一医院心内科收治的急性心肌梗死PCI术后患者212例。随访1年,根据是否再发心肌梗死分为再发心肌梗死组32例和对照组180例,比较2组临床特征,采用ROC曲线分析冠状动脉斑块负荷对老年急性心肌梗死患者PCI术后再发心肌梗死的预测价值。结果2组老年营养风险指数比较,差异无统计学意义(P>0.05)。再发心肌梗死组颈动脉内膜中层厚度[(1.44±0.17)mmvs(1.33±0.17)mm,P=0.000]、非钙化斑块负荷[(15.45±3.08)%vs(9.72±2.69)%,P=0.000]、钙化斑块负荷[(22.07±5.13)%vs(18.48±4.36)%,P=0.000]、总斑块负荷[(37.52±6.18)%vs(28.20±5.08)%,P=0.000]显著高于对照组,LVEF显著低于对照组[(58.09±7.16)%vs(66.50±7.83)%,P=0.000]。非钙化斑块负荷、钙化斑块负荷、总斑块负荷、颈动脉内膜中层厚度、LVEF对老年急性心肌梗死患者PCI术后再发心肌梗死均有一定预测价值(P<0.01),其中非钙化斑块负荷的预测价值最高,ROC曲线下面积为0.906(95%CI:0.848~0.965,P=0.000)。结论冠状动脉斑块负荷对预测老年急性心肌梗死患者PCI术后再发心肌梗死具有一定预测价值,可用于识别再发心肌梗死的高危人群。Objective To explore the predictive value of coronary plaque burden for recurrent myo-cardial infarction in elderly patients with acute myocardial infarction(AMI)after PCI.Methods A retrospective study was conducted on 212 AMI patients undergoing PCI in our hospital from January 2019 to December 2021.All of them were followed up for 1 year after surgery,and were divided into a recurrent myocardial infarction group(32 cases)and a control group(180 cases)based on whether they had recurrent myocardial infarction or not.The clinical characteristics were compared between the two groups.ROC curve was plotted to analyze the predictive value of coro-nary plaque burden for recurrent myocardial infarction in elderly AMI patients.ResulSs There was no statistical difference in the nutritional risk index between the two groups(P>0.05).The carotid intima media thickness(1.44±0.17 mm vs 1.33±0.17 mm,P=0.000),non-calcified plaque burden[(15.45±3.08)%ra(9.72±2.69)%,P=0.000],calcified plaque burden[(22.07±5.13)%ra(18.48±4.36)%,P=0.000],and total plaque burden[(37.52±6.18)%ra(28.20±5.08)%,P=0.000]were significantly higher,whde the LVEF value was lower[(58.09±7.16)%ra(66.50±7.83)%,P=0.000]in the recurrent group than the control group.Non-calcified plaque burden,calcified plaque burden,total plaque burden,carotid intima media thickness and LVEF were all valuabCe in predicting recurrent myocardial infarction in these patients after PCI(P<0.05).The predictive value of non-calcified plaque burden was the highest,with an area under the curve of 0.906(95%CI:0.848-0.965,P=0.000).Conclusion Coronary plaque burden is of certain value in predicting recurrent myocardial infarction in elderly AMI patients after PCI,and can be used to identify high-risk population for recurrent myocardial infarction.

关 键 词：心肌梗死 预测 经皮冠状动脉介入治疗 颈动脉狭窄 回顾性研究 斑块 

分 类 号：R542.22[医药卫生—心血管疾病]