解放军医学杂志2024，Vol.49Issue(4)：408-415,8.DOI:10.11855/j.issn.0577-7402.0866.2023.1208
肌肉减少指数对急性心肌梗死患者急诊PCI术后发生院内不良事件的预测价值
Sarcopenia index as a predictor of in-hospital adverse events in patients with acute myocardial infarction after emergency PCI
摘要
Abstract
Objective To investigate the association between the serum creatinine/cystatin C ratio(SCr/Cys C)as a Sarcopenia index(SI)and the incidence of in-hospital adverse events in patients with acute myocardial infarction(AMI)undergoing emergency percutaneous coronary intervention(PCI).Additionally,we evaluate the predictive efficacy of the SI in predicting major adverse cardiovascular events(MACEs)during hospitalization.Methods A total of 306 patients with AMI who underwent emergency PCI in the 904th Hospital of PLA Joint Logistics Support Force from January 2020 to March 2023 were consecutively included in this retrospective analysis.Patients were divided into two groups based on the occurrence of MACEs during hospitalization:MACEs group(n=43)and non-MACEs group(n=263).Clinical characteristics and pre-PCI laboratory test results were collected.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MACEs.The predictive performance of SI was assessed using receiver operating characteristic(ROC)curve analysis.Results The incidence of in-hospital MACEs in AMI patients was 14.1%.The results of the independent samples t-test showed that the SI level in MACEs group was significantly lower than that in non-MACEs group,with a statistically significant difference(P<0.001).The results of the multivariate logistic regression analysis suggested that new-onset atrial fibrillation,Killip class 2-4,SI,and TG were independent risk factors for in-hospital adverse events after emergency PCI.The ROC curve results showed that the predictive value of SI(AUC=0.741,95%CI 0.666-0.816)using the SCr/Cys C ratio was superior to that of single Cys C(AUC=0.658,95%CI 0.570-0.746)for predicting post-PCI MACEs,with a statistically significant difference(P<0.05),and the optimal cutoff value for SI was 78.14.After stratifying SI based on the cutoff value,the results of the independent samples t-test showed that compared to the higher SI group,the lower SI group had a higher occurrence of specific adverse events such as heart failure(P<0.001),malignant arrhythmias(P=0.009),and strokes(P=0.003),with statistically significant differences.Conclusions The results highlight SI as an independent risk factor for MACEs during hospitalization after emergency PCI in AMI patients.Furthermore,SI has proven to be an effective prognostic index for patient outcomes.关键词
肌肉减少指数/急性心肌梗死/主要不良心血管事件/血清肌酐/胱抑素C/经皮冠状动脉介入治疗Key words
Sarcopenia index/acute myocardial infarction/major adverse cardiovascular events/serum creatinine/cystatin C/percutaneous coronary intervention分类
医药卫生引用本文复制引用
李成思,王张羽,曹少清,王玉琴,叶江平,刘叶红,靳天慧,宗刚军..肌肉减少指数对急性心肌梗死患者急诊PCI术后发生院内不良事件的预测价值[J].解放军医学杂志,2024,49(4):408-415,8.基金项目
This work was supported by the Major Project of Jiangsu Commission of Health(ZD2021020) 江苏省卫健委重大课题(ZD2021020) （ZD2021020）
