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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

21卷

期数:

2015年01期

页码:

43-47

栏目:

出版日期:

2015-01-20

文章信息/Info

Title:

SYNTAX score and cardiovascular events in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

文章编号:

1006-8147（2015）0-0043-05

作者:

崔利军 ; 马向红 ; 段雯婷 ; 马军伟;  李 昭;  王爱芬

(天津医科大学第二医院心脏科,天津 300211)

Author(s):

CUI Li-jun;  MA Xiang-hong;  DUAN Wen-ting;  MA jun-wei;  LI Zhao;  WANG Ai-fen

（Department of Cardiology，The Second Hospital, Tianjin Medical University，Tianjin 300211, China）

关键词:

冠状动脉疾病; 急性ST段抬高型心肌梗死; SYNTAX积分; 冠状动脉造影;  经皮冠状动脉介入治疗

Keywords:

coronary artery disease;  acute ST-segment elevation myocardial infarction;  SYNTAX score;  cardioangiography;  ercutaneous coronary intervention

分类号:

R542.2+2

DOI:

-

文献标志码:

A

摘要:

目的：探讨SYNTAX积分对急性ST段抬高型心肌梗死（STEMI）患者急诊介入治疗术后院内及1年预后的预测作用。方法：连续纳入因急性 STEMI行急诊经皮冠状动脉介入治疗（PCI）的患者共312例，根据冠状动脉造影结果计算SYNTAX积分后分为3组，A组170例为基线SYNTAX积分（bSSC）＜22分；B组90例，bSSC＝22～32分；C组52例，bSSC＞32分。结果：（1）B组、C组与A组比较，合并糖尿病患者的比例较高，肌酸激酶同工酶（CK-MB）、尿酸（UA）及空腹血糖水平较高，差异有统计学意义，P＜0.05。（2）A、B、C3组患者院内严重不良心血管事件发生的比例分别是6.6%（n＝11）、31.1%（n＝28）、36.5%（n＝19），差异有统计学意义，P＜0.05。（3）入选患者平均随访(14.2±0.8)月， Kaplan-Meier生存分析显示，3组主要不良心血管事件(MACE)、全因死亡、非致死性心肌梗死、非计划再次PCI、因心力衰竭发作入院治疗的累积事件发生率有显著差异，log-rank P＜0.001。（4）多因素Cox回归分析显示，bSSC（HR＝1.059,95% CI 1.035～1.083,P＜0.001）、剩余SYNTAX积分（rSSC ）(HR＝1.056,95% CI 1.033～1.081,P＜0.001)是STEMI患者急诊PCI术后MACE的独立预测因子。 结论 ：院内及随访结果显示bSSC是STEMI患者急诊PCI术后MACE的独立预测因子。

Abstract:

Objective：To investigate the predictive effect of SYNTAX score for in-hospital and one-year prognosis outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods：A total of 312 patients with STEMI undergoing primary PCI were divided into three groups based on SYNTAX scores which were calculated by angiography results. Group A (n＝170) was defined as baseline SYNTAX score (bSSC) ＜22, group B bSSC＝22-32 (n＝90), group C bSSC＞32 (n＝52).Results：(1) Group B and group C had a higher proportion of patients with diabetes, a higher CK-MB, UA, fasting glucose compared with group A (P＜0.05). (2) The proportions of patients with severe adverse cardiovascular events in-hospital in three groups were 6.6% (n＝11), 31.1% (n＝28), 36.5% (n＝19) respectively (P＜0.05). (3) For patients whose follow-up periods were between (14.2±0.8) months, Kaplan-Meier survival analysis showed log-rank （P＜0.001 ) was found among major adverse cardiovascular events (MACE), all-cause death, non-fatal MI, unplanned revascularization for ischemia, rehospitalization due to heart failure. (4) By multivariable analysis, bSSC and rSSC were found to be significant independent predictor for all ischemic outcomes at year 1, including MACE (HR＝1.059, 95% CI: 1.035-1.083, P＜0.001; HR＝1.056, 95% CI: 1.033-1.081, P＜0.001). Conclusion：The SYNTAX score is an independent predictor for in-hospital as well as long-term mortality and MACE in patients with acute STEMI undergoing primary PCI.

参考文献/References:

[1]R?ber L, Kelb?k H, Ostojic M, et al. Effect of biolimus-eluting stents with biodegradable polymer vs bare-metal stents on cardiovascular events among patients with acute myocardial infarction: the COMFORTABLE AMI randomized trial[J]. JAMA, 2012,308(8):777
[2]Bonnefoy E, Kirkorian G. Mortality of myocardial infarction[J]. Ann Cardiol Angiol(Paris), 2011,60:311
[3]Sianos G, Morel M A, Kappetein A P, et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease[J]. EuroIntervention, 2005,1(2):219
[4]Serruys P W, Onuma Y, Garg S, et al. Assessment of the SYNTAX score in the Syntax study[J]. EuroIntervention, 2009,5(1):50
[5]Généreux P, Palmerini T, Caixeta A, et al. Quantification and impact of untreated coronary artery disease after percutaneous coronary intervention: the residual SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) score[J]. J Am Coll Cardiol, 2012,59(24):2165
[6]Capodanno D. Beyond the SYNTAX score--advantages and limitations of other risk assessment systems in left main percutaneous coronary intervention[J]. Circ J, 2013,77(5):1131
[7]Farooq V, Head S J, Kappetein A P, et al. Widening clinical applications of the SYNTAX Score[J]. Heart, 2014,100(4):276
[8]Head S J, Farooq V, Serruys P W, et al. The SYNTAX score and its clinical implications[J]. Heart, 2014,100(2):169
[9]Akgun T, Oduncu V, Bitigen A, et al. Baseline SYNTAX score and Long-Term outcome in patients with ST-Segment elevation myocardial infarction undergoing primary percutaneous coronary intervention[J]. Clin Appl Thromb Hemost, 2014
[10]Yang C H, Hsieh M J, Chen C C, et al. SYNTAX score: an Independent predictor of long-term cardiac mortality in patients with acute ST-elevation myocardial infarction[J]. Coron Artery Dis, 2012,23(7):445
[11]Wald D S, Morris J K, Wald N J, et al. Randomized trial of preventive angioplasty in myocardial infarction[J]. N Engl J Med, 2013,369(12):1115
[12]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[J].中华心血管病杂志， 2010,38(8):675
[13]Magro M, Nauta S T, Simsek C, et al. Usefulness of the SYNTAX score to predict "no reflow" in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction[J]. Am J Cardiol, 2012,109(5):601
[14]Farooq V, Vergouwe Y, R?ber L, et al. Combined anatomical and clinical factors for the long-term risk stratification of patients undergoing percutaneous coronary intervention: the Logistic Clinical SYNTAX score[J]. Eur Heart J, 2012,33(24):3098
[15]Farooq V, Serruys P W, Bourantas C V, et al. Quantification of incomplete revascularization and its association with five-year mortality in the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) trial validation of the residual SYNTAX score[J]. Circulation, 2013,128(2):141
[16]Biondi-Zoccai G, Lotrionte M, Sheiban I. Management of multivessel coronary disease after ST-elevation myocardial infarction treated by primary coronary angioplasty[J]. Am Heart J, 2010,160(6 Suppl):S28

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备注/Memo

备注/Memo:

作者简介崔利军（1987-），男，硕士在读，研究方向：心血管内科；

通信作者：马向红，E-mail: ma_xianghong@163.com。

 

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更新日期/Last Update: 2015-06-10