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首页> 外文期刊>Circulation journal >A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction
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A Practical Risk Score to Predict 24-Month Post-Discharge Mortality Risk in Patients With Non-ST-Segment Elevation Myocardial Infarction

机译：实际风险评分预测非ST段抬高心肌梗死患者的24个月后后死亡率风险

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Background: Risk stratification of patients with non-ST-segment elevation myocardial infarction (NSTEMI) is important in terms of treatment strategy selection. Current efforts have focused on short-term risk prediction after discharge, but we aimed to establish a risk score to predict the 24-month mortality risk in survivors of NSTEMI. Methods?and?Results: A total of 5,509 patients diagnosed with NSTEMI between January 2013 and September 2014 were included. Primary endpoint was all-cause death at 24 months. A multivariable Cox regression model was used to establish a practical risk score based on independent risk factors of death. The risk score included 9 variables: age, body mass index, left ventricular ejection fraction, reperfusion therapy during hospitalization, Killip classification, prescription of diuretics at discharge, heart rate, and hemoglobin and creatinine levels. The C-statistics for the risk model were 0.83 (95% confidence interval [CI]: 0.81–0.85) and 0.83 (95% CI: 0.79–0.86) in the development and validation cohorts, respectively. Mortality risk increased significantly across groups: 1.34% in the low-risk group (score: 0–58), 5.40% in intermediate group (score: 59–93), and 23.87% in high-risk group (score: ≥94). Conclusions: The current study established and validated a practical risk score based on 9 variables to predict 24-month mortality risk in patients who survive NSTEMI. This score could help identify patients who are at high risk for future adverse events who may benefit from good adherence to guideline-recommended secondary prevention treatment.
机译：背景：非ST段升高患者的风险分层心肌梗死（NSTEMI）在治疗策略选择方面是重要的。目前的努力专注于出院后的短期风险预测，但我们旨在建立风险分数，以预测NSTemi的幸存者中的24个月死亡率风险。方法？结果：在2013年1月至2014年1月期间，共有5,509名诊断为NStemi患者。主要终点是24个月的全因死。使用多变量的Cox回归模型来建立基于独立死亡风险因素的实际风险分数。风险得分包括9个变量：年龄，体重指数，左心室喷射分数，住院期间的再灌注治疗，杀死分类，利尿剂处置，放电，心率和血红蛋白和肌酐水平。风险模型的C统计学分别为0.83（95％置信区间[CI]：0.81-0.85）和0.83（95％CI：0.79-0.86），分别在开发和验证队列中。群体中的死亡率显着增加：低风险群体（得分：0-58），中间组（得分：59-93），5.40％，高风险群体（得分：≥94） 。结论：目前的研究建立并验证了基于9个变量的实际风险评分，以预测生存Nstemi的患者的24个月死亡风险。此分数可以帮助识别可能从良好遵守指南推荐的二级预防治疗的未来不良事件风险的患者。

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