TIMI 评分作为 STEMI 患者冠状动脉疾病严重程度的预测指标。

Syed Kashif ur Rahman, M. A. Khan, Muzafar Ali Surhio, M. H. Kalwar, Mashooq Ali Dasti, Mahmood Ul Hassan, Dr. Muhammad Abbas Khan
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摘要

目的研究将 TIMI(心肌梗死溶栓治疗)评分作为评估 ST 段抬高型心肌梗死(STEMI)患者冠状动脉疾病严重程度的预测工具。研究设计:前瞻性观察队列研究。研究地点白沙瓦哈亚塔巴德医疗中心。时间: 2021 年 1 月至 2022 年 6 月2021 年 1 月至 2022 年 6 月。材料与方法在参与医院急诊科就诊的 STEMI 连续患者均被纳入考虑范围。纳入标准包括年龄在 21 岁或以上、症状与 STEMI 一致、心电图(ECG)上两个或多个连续导联 ST 段抬高至少 1 毫米的患者。已知有冠状动脉疾病或既往心肌梗死病史的患者不在研究范围内。研究结果患者年龄差异较大,平均年龄(60.18±15.38)岁。性别分布显示男性居多,占样本的 67.79%,女性占 32.20%。在合并症方面,22.03%的患者肥胖,52.54%的患者患有糖尿病,18.64%的患者患有高血压,25.42%的患者患有高脂血症,11.86%的患者有心肌梗死家族史,47.45%的患者吸烟。中度风险组的发病率较低,为 71.11%,而高度风险组的发病率最低,为 50%。这一比较的 P 值为 0.0001,具有高度显著性,表明在这些风险组别中,左心室功能障碍的发生率存在很大差异。结论我们的研究表明,TIMI 风险组别与心肌梗死后并发症(包括左心室功能障碍、心律失常、心源性休克和死亡)的发生之间存在密切联系。
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TIMI score as a predictor of severity of coronary artery disease in patients with STEMI.
Objective: To investigate the TIMI (Thrombolysis in Myocardial Infarction) score as a predictive tool for assessing the severity of coronary artery disease in patients presenting with ST-segment elevation myocardial infarction (STEMI). Study Design: Prospective, Observational Cohort study. Setting: Hayatabad Medical Complex Peshawar. Period: January 2021 to June 2022. Material & Methods: Consecutive patients presenting with STEMI to the emergency department of the participating hospital was considered for inclusion. Inclusion criteria were including patients aged 21 years or older, with symptoms consistent with STEMI and ST-segment elevation of at least 1 mm in two or more contiguous leads on the electrocardiogram (ECG). Patients with a known history of coronary artery disease or previous myocardial infarction were excluded from the study. Results: The age of the patients ranged widely, with a mean±SD age of 60.18±15.38 years. Gender distribution showed a predominance of males, constituting 67.79% of the sample, while females accounted for 32.20%. In terms of comorbidities, 22.03% of patients were obese, 52.54% had diabetes mellitus, 18.64% had hypertension, 25.42% had hyperlipidemia, 11.86% had a family history of myocardial infarction, and 47.45% were smokers. Moderate risk group shows a lower incidence at 71.11%, and the High risk group has the lowest incidence at 50%. The p-value for this comparison is highly significant at 0.0001, indicating that there is a substantial difference in the occurrence of LV dysfunction among these risk groups. Conclusion: Our study demonstrates a strong association between TIMI risk groups and the occurrence of post-myocardial infarction complications, including LV dysfunction, arrhythmias, cardiogenic shock, and death.
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