三种评分对经皮冠状动脉介入治疗急性非ST段抬高心肌梗死患者的预测价值比较

Predictve value of ACUITY-PCI,GRACE and SYNTAX scores for non-ST segment elevation acute myocardial infarction patients undergoing PCI

目的 探讨ACUITY-PCI评分与GRACE评分和SYNTAX评分对接受PCI的急性非ST段抬高心肌梗死（NSTEMI）患者预后的预测价值.方法 收集252例NSTEMI患者临床资料.对每例患者进行ACUITY-PCI、GRACE和SYNTAX评分,随访1年,随访终点为主要不良心血管事件（全因死亡,非致命性心肌梗死、再次血运重建）.将3种评分方法对终点事件预测价值进行比较和分析.结果 GRACE评分、SYNTAX评分及ACUITY-PCI评分预测NSTEMI患者1年主要不良心血管事件的ROC曲线下面积呈依次递增趋势,其准确性分别为0.627（95％CI：0.535～0.720）,0.671（95％CI：0.589～0.753）,0.754（95％CI：0.689～0.802）.3种评分方法均具有良好的拟合优度,其中ACUITY-PCI评分同时具备较好的准确性和拟合优度.结论 ACUITY-PCI评分可预测接受PCI的NSTEMI患者预后,其同时具备较好的准确性和拟合优度.

Objective To study the predictive value of ACUITY-PCI,GRACE and SYNTAX scores for non-ST segment elevation acute myocardial infarction （NSTEMI） patients undergoing PCI.Methods Clinical data of 252 NSTEMI patients were retrospectively analyzed.Their ACUITY-PCI,GRACE and SYNTAX scores were recorded.The patients were followed up for 1 year,during which the major adverse cardiac events （MACE） compared and analyzed according to the ACUITY-PCI,GRACE and SYNTAX scores.Results The ACUITY-PCI,GRACE and SYNTAX scores could predict the 1 year follow-up MACE in NSTEMI patients with the area under the ROC curve increased gradually.Their accuracy was 0.627 （95％CI：0.535-0.720）,0.671 （95％CI：0.589-0.753） and 0.754 （95％CI：0.689-0.802）,respectively.The accuracy and calibration of ACUITY-PCI score were better than those of GRACE and SYNTAX scores.Conclusion ACUITY-PCI score can predict the outcome in NSTEMI patients undergoing PCI with a rather good accuracy and calibration.