SCAMI-NSTEMI评分优化NSTEMI患者死亡风险预测及院前急救策略的临床研究

SCAMI-NSTEMI score improves the risk assessment and optimizes pre-hospital care strategy for non-ST-segment elevation myocardial infarction patients

目的在非ST段抬高型心肌梗死(NSTEMI)人群中对基于中国急性心肌梗死(AMI)注册研究建立的简化NSTEMI(SCAMI-NSTEMI)评分进行验证,并与全球急性冠状动脉事件(GRACE)评分进行比较,探索其对院前急救策略的影响。方法入选2019年1月至2019年12月NSTEMI患者279例,收集患者的基线资料和死亡等数据,分别计算每例患者的SCAMI-NSTEMI评分和GRACE评分,并利用受试者工作特征(ROC)曲线下面积(AUC)和净重新分类指数(net reclassification imporvement,NRI)等方法对评分进行验证和比较。结果与GRACE评分比较,SCAMI-NSTEMI评分表现出更优秀的分辨能力[AUC=0.789,95%置信区间(CI):0.734~0.834]和分类能力(NRI=43.61%,P<0.0001),并且更准确、有效地识别高危患者。结论SCAMINSTEMI评分能够改善NSTEMI患者死亡风险的预测,并在此基础上指导优化NSTEMI患者院前急救策略。

Objective To validate and compare the performance of simplified China Acute Myo-cardial Infarction(SCAMI)-non-ST-segment elevation myocardial infarction(NSTEMI)score and Global Registry of Acute Coronary Events(GRACE)score and to investigate the impact of SCAMI-NSTEMI score on pre-hospital care strategy for NSTEMI patients.Methods Baseline information and in-hospital mortality of 279 NSTEMI patients between January 2019 and December 2019 were collected.SCAMI-NSTEMI score and GRACE score for every patient were estimated,respectively.Area under the ROC curve(AUC)and net reclassification improvement(NRI)were used to validate and compare the performance of scores.Results Compared with GRACE score,SCAMI-NSTEMI score demonstrated better ability of discrimination(AUC=0.789,95%confidence interval:0.734-0.834)and classification(NRI=43.61%,P<0.0001),resulting in effective identification of high risk patients.Conclusions SCAMI-NSTEMI score provides more accurate risk assessment and optimizes pre-hospital care strategy for NSTEMI patients.