中国全科医学2017，Vol.20Issue(15)：1833-1838,6.DOI:10.3969/j.issn.1007-9572.2017.15.010
Grace评分联合Crusade评分对心房颤动合并非ST段抬高型心肌梗死患者PCI术后远期预后的预测价值
Predictive Value for Long-term Prognosis of Grace and Crusade Scores in Patients with Atrial Fibrillation and NSTEMI after PCI
摘要
Abstract
Objective To clarify the value of Grace and Crusade scores for predicting the risk of long-term all-cause mortality and major adverse cardiovascular events in patients with atrial fibrillation and non-ST-elevation myocardial infarction(NSTEMI) after percutaneous coronary intervention(PCI).Methods A retrospective study was conducted on the data of 379 patients with atrial fibrillation and NSTEMI treated by PCI in 11 tertiary grade A hospitals in Beijing from January 2010 to January 2015.Grace score,Crusade score,Grace unite Crusade scores were used to predict the long-term prognosis of these patients.The area under the curve(AUC) of receiver operating characteristic(ROC) of these three predictors were recorded.In accordance with the results of combined assessment of Grace and Crusade scores,the patients were divided into four groups,G1 group(Grace score ≤118 points,Crusade score≤40 points,n=112),G2 group(Grace score ≤118 points,Crusade score ≥41 points,n=20),G3 group(Grace score >118 points,Crusade score ≤40 points,n=143) and G4 group(Grace score >118 points,Crusade score ≥ 41 points,n=104).The area under the curve(AUC) of receiver operating characteristic(ROC) of these three predictors were recorded.The survival curves of 4 groups were drawn and compared.Results Three hundred and sixty-two of the 379 recruited patients completed the follow-up of(36.8±18.3)months.For predicting the risk of long-term all-cause mortality of these participants,the AUC of Grace score,Crusade score,Grace unite Crusade scores respectively were 0.660 〔95%CI(0.609,0.709)〕,0.702 〔95%CI(0.652,0.749)〕,and 0.707 〔95%CI(0.658,0.754)〕.As for predicting the risk of long-term major adverse cardiovascular events,the AUC of Grace score,Crusade score,Grace unite Crusade scores respectively were 0.559 〔95%CI(0.506,0.611)〕,0.593 〔95%CI(0.540,0.644)〕,0.594 〔95%CI(0.542,0.645)〕.Survival analysis found that survival curve differed significantly among the G1,G2,G3 and G4 groups(χ2=20.07,P<0.01);G4 group had substantially lower survival rate than G1 and G3 groups(P<0.05).Conclusion For patients with atrial fibrillation and NSTEMI after PCI,these three predictors have certain predictive values in predicting the risk of long-term all-cause mortality,of them,Grace unite Crusade scores can be used for identifying the high-risk patients.The three predictors have similar values in predicting the risk of long-term major adverse cardiovascular events in these patients.关键词
心房颤动/心肌梗死/Grace评分/Crusade评分/血管成形术,经腔,经皮冠状动脉Key words
Atrial fibrillation/Myocardial infarction/Grace score/Crusade score/Angioplasty,transluminal,percutaneous coronary分类
医药卫生引用本文复制引用
王楠楠,张博阳,刘鹏飞,王宇彬,王峰,袁海凤,谢秀峰,唐海红,李田昌..Grace评分联合Crusade评分对心房颤动合并非ST段抬高型心肌梗死患者PCI术后远期预后的预测价值[J].中国全科医学,2017,20(15):1833-1838,6.基金项目
首都临床特色应用研究与成果推广(Z151100004015205) （Z151100004015205）
