Predictive value of simple predictive model for prognosis of patients with acute ST-segment elevation myocardial infarction_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YU Jing ^1,2 , LI Dongze ^1,2 , JIA Yu ^1,2 , CHENG Yisong ^1,2 , GAO Yongli ^1,2 , ZENG Rui ³ ,  WAN Zhi ^1,2

1. Department of Emergence Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Disaster Medical Center, Sichuan University, Chengdu, 610041, P.R.China;
3. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WAN Zhi, Email: 303680215@qq.com

Keywords：

Acute ST-segment elevation myocardial infarction; predictive model; prognosis

DOI：

10.7507/1007-4848.202012028

Video：

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Objective To explore the predictive value of a simple prediction model for patients with acute myocardial infarction.Methods Clinical data of 280 patients with acute ST-segment elevation myocardial infarction (STEMI) in the Department of Emergence Medicine, West China Hospital of Sichuan University from January 2019 to January 2020 were retrospectively analyzed. The patients were divided into a death group (n=34) and a survival group (n=246).Results Age, heart rate, body mass index (BMI), global registry of acute coronary events (GRACE), thrombolysis in myocardial infarction trial (TIMI) score, blood urea nitrogen, serum cystatin C and D-dimer in the survival group were less or lower than those in the death group (P<0.05). Left ventricle ejection fraction and the level of albumin, triglyceride, total cholesterol and low density lipoprotein cholesterol were higher and the incidence of Killip class≥Ⅲ was lower in the survival group compared to the death group (P<0.05). Multivariate logistic regression analysis showed that age, BMI, heart rate, diastolic blood pressure, and systolic blood pressure were independent risk factors for all-cause death in STEMI patients. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of simple prediction model for predicting death was 0.802, and similar to that of GRACE (0.816). The H-L test showed that the simple model had high accuracy in predicting death (χ²=3.77, P=0.877). Pearson correlation analysis showed that the simple prediction model was significantly correlated with the GRACE (r=0.651, P<0.001) and coronary artery stenosis score (r=0.210, P=0.001).Conclusion The simple prediction model may be used to predict the hospitalization and long-term outcomes of STEMI patients, which is helpful to stratify high risk patients and to guide treatment.

Citation： YU Jing, LI Dongze, JIA Yu, CHENG Yisong, GAO Yongli, ZENG Rui, WAN Zhi. Predictive value of simple predictive model for prognosis of patients with acute ST-segment elevation myocardial infarction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(11): 1346-1351. doi: 10.7507/1007-4848.202012028 Copy

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5.	中华医学会心血管病学分会中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2015, 43(5): 380-393.
6.	Li DZ, Yu J, Du RS, et al. Thrombo-inflammatory status and prognosis of acute type A aortic dissection. Herz, 2016, 41(3): 250-251.
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8.	Sakakura K, Kubo N, Ako J, et al. Peak C-reactive protein level predicts long-term outcomes in type B acute aortic dissection. Hypertension, 2010, 55(2): 422-429.
9.	涂代苗, 阚晨星, 马向红. 不同年龄段急性心肌梗死患者冠脉病变情况及临床特征分析. 天津医药, 2020, 48(5): 434-438.
10.	Gupta T, Kolte D, Mohananey D, et al. Relation of obesity to survival after in-hospital cardiac arrest. Am J Cardiol, 2016, 118(5): 662-667.
11.	王欢欢, 赵雪燕, 高展, 等. 体重指数对行介入治疗的急性ST段抬高型心肌梗死患者长期预后的影响. 中国循环杂志, 2017, 32(4): 348-352.
12.	Berger M, Raffin J, Pichot V, et al. Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial. Scand J Med Sci Sports, 2019, 29(8): 1254-1262.
13.	Alfredsson J, Alexander KP. Multiple chronic conditions in older adults with acute coronary syndromes. Clin Geriatr Med, 2016, 32(2): 291-303.
14.	Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J, 2002, 23(15): 1190-1201.
15.	Pedrinelli R, Ballo P, Fiorentini C, et al. Hypertension and acute myocardial infarction: An overview. J Cardiovasc Med (Hagerstown), 2012, 13(3): 194-202.
16.	Erne P, Radovanovic D, Schoenenberger AW, et al. Impact of hypertension on the outcome of patients admitted with acute coronary syndrome. J Hypertens, 2015, 33(4): 860-867.
17.	Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med, 2003, 163(19): 2345-2353.
18.	Kaplan RC, Heckbert SR, Furberg CD, et al. Predictors of subsequent coronary events, stroke, and death among survivors of first hospitalized myocardial infarction. J Clin Epidemiol, 2002, 55(7): 654-664.
19.	Hassan AKM, Abd-El Rahman H, Mohsen K, et al. Impact of in-hospital blood pressure variability on cardiovascular outcomes in patients with acute coronary syndrome. J Clin Hypertens (Greenwich), 2017, 19(12): 1252-1259.

1. Gao R, Patel A, Gao W, et al. Prospective observational study of acute coronary syndromes in China: Practice patterns and outcomes. Heart, 2008, 94(5): 554-560.
2. Kristensen SD, Laut KG, Fajadet J, et al. Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: Current status in 37 ESC countries. Eur Heart J, 2014, 35(29): 1957-1970.
3. Fox KA, Carruthers KF, Dunbar DR, et al. Underestimated and under-recognized: The late consequences of acute coronary syndrome (GRACE UK-Belgian Study). Eur Heart J, 2010, 31(22): 2755-2764.
4. Stepinska J, Lettino M, Ahrens I, et al. Diagnosis and risk stratification of chest pain patients in the emergency department: Focus on acute coronary syndromes. A position paper of the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care, 2020, 9(1): 76-89.
5. 中华医学会心血管病学分会中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南. 中华心血管病杂志, 2015, 43(5): 380-393.
6. Li DZ, Yu J, Du RS, et al. Thrombo-inflammatory status and prognosis of acute type A aortic dissection. Herz, 2016, 41(3): 250-251.
7. Li D, Ye L, Yu J, et al. Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection. Oncotarget, 2017, 8(45): 79315-79322.
8. Sakakura K, Kubo N, Ako J, et al. Peak C-reactive protein level predicts long-term outcomes in type B acute aortic dissection. Hypertension, 2010, 55(2): 422-429.
9. 涂代苗, 阚晨星, 马向红. 不同年龄段急性心肌梗死患者冠脉病变情况及临床特征分析. 天津医药, 2020, 48(5): 434-438.
10. Gupta T, Kolte D, Mohananey D, et al. Relation of obesity to survival after in-hospital cardiac arrest. Am J Cardiol, 2016, 118(5): 662-667.
11. 王欢欢, 赵雪燕, 高展, 等. 体重指数对行介入治疗的急性ST段抬高型心肌梗死患者长期预后的影响. 中国循环杂志, 2017, 32(4): 348-352.
12. Berger M, Raffin J, Pichot V, et al. Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial. Scand J Med Sci Sports, 2019, 29(8): 1254-1262.
13. Alfredsson J, Alexander KP. Multiple chronic conditions in older adults with acute coronary syndromes. Clin Geriatr Med, 2016, 32(2): 291-303.
14. Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J, 2002, 23(15): 1190-1201.
15. Pedrinelli R, Ballo P, Fiorentini C, et al. Hypertension and acute myocardial infarction: An overview. J Cardiovasc Med (Hagerstown), 2012, 13(3): 194-202.
16. Erne P, Radovanovic D, Schoenenberger AW, et al. Impact of hypertension on the outcome of patients admitted with acute coronary syndrome. J Hypertens, 2015, 33(4): 860-867.
17. Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med, 2003, 163(19): 2345-2353.
18. Kaplan RC, Heckbert SR, Furberg CD, et al. Predictors of subsequent coronary events, stroke, and death among survivors of first hospitalized myocardial infarction. J Clin Epidemiol, 2002, 55(7): 654-664.
19. Hassan AKM, Abd-El Rahman H, Mohsen K, et al. Impact of in-hospital blood pressure variability on cardiovascular outcomes in patients with acute coronary syndrome. J Clin Hypertens (Greenwich), 2017, 19(12): 1252-1259.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Predictive value of simple predictive model for prognosis of patients with acute ST-segment elevation myocardial infarction

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