AMI患者发生NOAF的影响因素及CHA_(2)DS_(2)-VASc评分联合NT-proBNP的预测价值

Influencing Factors of NOAF in Patients with AMI and the Predictive Value of CHA_(2)DS_(2)-VASc Score Combined with NT-proBNP

目的:探讨急性心肌梗死(acute myocardial infarction,AMI)患者发生新发心房颤动(new-onset atrial fibrillation,NOAF)的影响因素及CHA_(2)DS_(2)-VASc评分联合N末端B型脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)的预测价值。方法:选取2019年2月—2022年6月在鄂钢医院心血管内科住院治疗的378例AMI患者作为研究对象。根据住院治疗期间是否发生NOAF将其分为非NOAF组(336例)和NOAF组(42例)。收集两组临床资料及治疗情况。比较两组临床资料及治疗情况,对AMI患者发生NOAF进行多因素分析,分析CHA_(2)DS_(2)-VASc评分联合NT-proBNP的预测价值。结果:NOAF组ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)、右冠状动脉病变占比,NT-proBNP、左心房内径(left atrial diameter,LAD)、CHA_(2)DS_(2)-VASc评分均高于非NOAF组,左心室射血分数(left ventricular ejection fraction,LVEF)低于非NOAF组,差异有统计学意义(P<0.05)。NT-proBNP高水平、CHA_(2)DS_(2)-VASc评分升高、LVEF下降均为AMI患者发生NOAF的危险因素(P<0.05)。CHA_(2)DS_(2)-VASc评分联合NT-proBNP预测AMI患者发生NOAF的AUC值、敏感度及特异度均优于单一指标检测。结论:CHA_(2)DS_(2)-VASc评分联合NT-proBNP预测AMI患者发生NOAF的临床价值较好。

Objective:To investigate the influencing factors of new-onset atrial fibrillation(NOAF)in patients with acute myocardial infarction(AMI)and the predictive value of CHA_(2)DS_(2)-VASc score combined with N-terminal pro-brain natriuretic peptide(NT-proBNP).Method:From February 2019 to June 2022,378 patients with AMI who were hospitalized for treatment in the Department of Cardiovascular Medicine of Egang Hospital were selected as the research objects.According to whether NOAF occurred during hospitalization treatment,they were divided into non-NOAF group(336 cases)and NOAF group(42 cases).The clinical data and treatment condition of the two groups were collected.The clinical data and treatment condition of the two groups were compared.Multivariate analysis was conducted for NOAF in patients with AMI.The predictive value of CHA_(2)DS_(2)-VASc score combined with NT-proBNP was analyzed.Result:The proportion of ST-elevation myocardial infarction(STEMI),right coronary artery disease,NT-proBNP,left atrial diameter(LAD)and CHA_(2)DS_(2)-VASc score in NOAF group were higher than those in non-NOAF group,the left ventricular ejection fraction(LVEF)in the NOAF group was lower than that in the non-NOAF group,and the differences were statistically significant(P<0.05).High level of NT-proBNP,increased CHA_(2)DS_(2)-VASc score and decreased LVEF were risk factors for NOAF in AMI patients(P<0.05).The AUC value,sensitivity and specificity of CHA_(2)DS_(2)-VASc score combined with NT-proBNP in predicting NOAF in AMI patients were better than those of single index detection.Conclusion:The CHA_(2)DS_(2)-VASc score combined with NT-proBNP has a good clinical value in predicting NOAF in patients with AMI.