CHA2DS2-VASc评分作为经皮冠状动脉介入治疗的非st段抬高型心肌梗死患者新发房颤的预测因子

mehdi karasu, erkan m, y karaca, mehmet kobat
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摘要

背景:新发心房颤动(NOAF)常并发急性冠状动脉综合征(ACSs),具有不良的短期和长期后果。然而,目前用于估计非st段抬高型心肌梗死(NSTEMI)期间NOAF的风险分类模型仍不清楚。CHA2DS2-VASc评分中的一些参数与房颤(AF)的发生密切相关。方法:本回顾性研究纳入了670例于2020年6月至2022年6月期间向我中心申请并接受经皮冠状动脉介入治疗(PCI)的连续NSTEMI患者。结果:住院期间发生NOAF 55例(12.5%)。NOAF患者年龄较大,高敏c -反应蛋白(hs-CRP)、左房容积指数、PCI后心肌梗死溶栓(TIMI)分级<3、CHA2DS2-VASc评分、肌钙蛋白I峰值(ng/ml)、SYNTAX评分(SS)均较高。经单因素logistic回归分析NOAF发展的预测因子,CHA2DS2-VASc评分、PCI后TIMI分级<3、血红蛋白、hsCRP、SS单独为NOAF的预测因子,多因素分析CHA2DS2-VASc评分、PCI后TIMI分级<3、血红蛋白具有决定性作用。结论:CHA2DS2-VASc评分可作为NSTEMI患者PCI术后NOAF的预测指标。除CHA2DS2-VASc评分外,PCI后TIMI分级<3和低血红蛋白水平是NSTEMI-NOAF的独立危险因素。
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CHA2DS2-VASc Score as a Predictor of New Onset Atrial Fibrillation in Patients With Non-ST Segment Elevation Myocardial Infarction Who Underwent Percutaneous Coronary Intervention
Background: New-onset atrial fibrillation (NOAF) often complicates acute coronary syndromes (ACSs) with adverse short- and long-term consequences. However, the current risk classification model for estimating NOAF during non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear. Some parameters in the CHA2DS2-VASc score are closely related to the development of atrial fibrilation (AF). Methods: This retrospective study was conducted among 670 consecutive NSTEMI patients who applied to our cardiovascular center between June 2020 and June 2022 and underwent percutaneous coronary intervention (PCI). Results: NOAF developed during hospitalization in 55 patients (12.5%). NOAF patients were older and had higher high sensitivity C-reactive protein (hs-CRP), left atrial volume index, Post PCI thrombolysis in myocardial infarction (TIMI) grade <3, CHA2DS2-VASc score, peak troponin I (ng/ml), and SYNTAX score (SS). After univariate logistic regression analysis for the predictors of NOAF development, CHA2DS2-VASc score, post PCI TIMI grade <3, hemoglobin, hsCRP, SS alone were predictors of NOAF, but after multivariate analysis, CHA2DS2-VASc score, post PCI TIMI grade <3, hemoglobin had a determining effect. Conclusions: The CHA2DS2-VASc score can be evaluated as a predictor of NOAF after PCI in NSTEMI. Except for the components of the CHA2DS2-VASc score, post PCI TIMI grade <3 and low hemoglobin levels are independent risk factors for NSTEMI-NOAF.
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