急性心肌梗死后死亡危险因素和临床风险预测模型研究进展

Predictors and clinical risk models of death after acute myocardial infarction

急性心肌梗死(AMI)是目前危害人类健康,造成老年人死亡的重要原因之一。除了年龄、性别、高血压、糖尿病、肾功能不全、心力衰竭及部分生物标志物(如肌钙蛋白、C反应蛋白等)等独立危险因素外,一些多变量的风险预测模型(如GRACE风险评分、TIMI风险评分、ACTION-GWTG风险评分、SILVER-AMI 6个月死亡风险评分和CLIP风险评分)能够更准确地预测AMI后死亡风险。临床医生通过了解AMI后死亡的预测因素,合理应用临床风险预测模型进行危险分层,可以较为准确、直观地判断患者预后,从而选择更为合理的治疗方案。

Acute myocardial infarction(AMI)is still one of the most important causes of human health and mortality.Age,gender,hypertension,diabetes,renal insufficiency,heart failure,and some biomarkers(such as cardiac troponin,C-reactive protein,etc.)are independent risk factors for death after AMI.Multivariate risk prediction models,such as GRACE,TIMI,AR-G,SILVER-AMI 6-month risk of death,and CLIP,are more accurate in predicting the risk of death after AMI.By understanding the predictors of death after AMI and reasonably applying the risk prediction models to risk stratification,clinicians can accurately and intuitively judge the prognosis of patients and choose a more reasonable treatment plan.