SAMe-TT_(2)R_(2)积分与CHA_(2)DS_(2)-VASc-60卒中评分对持续性非瓣膜性心房颤动患者治疗目标范围内的时间百分比未达标的预测价值

Predictive Value of SAMe-TT_(2)R_(2)Score and CHA_(2)DS_(2)-VASc-60 Stroke Score for Time Within Therapeutic Range Non-Compliance in Patients with Persistent Non Valvular Atrial Fibrillation

目的分析SAMe-TT_(2)R_(2)积分与CHA_(2)DS_(2)-VASc-60卒中评分对持续性非瓣膜性心房颤动患者治疗目标范围内的时间百分比(TTR)未达标的预测价值。方法回顾性选取2020—2022年就诊于九江市第一人民医院的持续性非瓣膜性心房颤动患者107例为研究对象。收集患者的一般资料、SAMe-TT_(2)R_(2)积分、CHA_(2)DS_(2)-VASc-60卒中评分。根据TTR达标情况将患者分为TTR达标组(32例)和TTR未达标组(75例)。两变量间的相关性分析采用Pearson相关分析;采用ROC曲线分析SAMe-TT_(2)R_(2)积分与CHA_(2)DS_(2)-VASc-60卒中评分对持续性非瓣膜性心房颤动患者TTR未达标的预测价值。结果TTR达标组年龄≥60岁者占比、SAMe-TT_(2)R_(2)积分低于TTR未达标组,吸烟者占比、CHA_(2)DS_(2)-VASc-60卒中评分高于TTR未达标组(P<0.05)。Pearson相关分析结果显示,持续性非瓣膜性心房颤动患者SAMe-TT_(2)R_(2)积分与TTR呈正相关(r=0.766,P<0.001),CHA_(2)DS_(2)-VASc-60卒中评分与TTR呈负相关(r=-0.622,P<0.001)。ROC曲线分析结果显示,SAMe-TT_(2)R_(2)积分与CHA_(2)DS_(2)-VASc-60卒中评分预测持续性非瓣膜性心房颤动患者TTR未达标的AUC分别为0.821[95%CI(0.733~0.909)]、0.939[95%CI(0.896~0.982)],最佳截断值分别为5.5、2.5分,灵敏度分别为0.719、0.813,特异度分别为0.813、0.933。结论SAMe-TT_(2)R_(2)积分对持续性非瓣膜性心房颤动患者TTR未达标具有一定预测价值,而CHA_(2)DS_(2)-VASc-60卒中评分对其具有较高预测价值。

Objective To analyze the predictive value of SAMe-TT_(2)R_(2)score and CHA_(2)DS_(2)-VASc-60 stroke score for time within therapeutic range(TTR)non-compliance in patients with persistent non valvular atrial fibrillation.Methods A total of 107 patients with persistent non valvular atrial fibrillation admitted to Jiu Jiang NO.1 People's Hospital from 2020 to 2022 were retrospectively selected as the study objects.General data,SAMe-TT_(2)R_(2)score and CHA_(2)DS_(2)-VASc-60 stroke score of the patients were collected.According to TTR compliance,the patients were divided into TTR compliance group(32 cases)and TTR non-compliance group(75 cases).Pearson correlation analysis was used to analyze the correlation between two variables.ROC curve was used to analyze the predictive value of SAMe-TT_(2)R_(2)score and CHA_(2)DS_(2)-VASc-60 stroke score for TTR non-compliance in patients with persistent non valvular atrial fibrillation.Results The proportion of patients aged≥60 years and SAMe-TT_(2)R_(2)score in TTR compliance group were lower than those in TTR non-compliance group,and the proportion of smokers and CHA_(2)DS_(2)-VASc-60 stroke score were higher than those in TTR non-compliance group(P<0.05).Pearson correlation analysis results showed that the SAMe-TT_(2)R_(2)score was positively correlated with TTR in patients with persistent non valvular atrial fibrillation(r=0.766,P<0.001),while the CHA_(2)DS_(2)-VASc-60 stroke score was negatively correlated with TTR(r=-0.622,P<0.001).ROC curve analysis results showed that the AUC of SAMe-TT_(2)R_(2)score and CHA_(2)DS_(2)-VASc-60 stroke score in predicting TTR non-compliance in patients with persistent non valvular atrial fibrillation was 0.821[95%CI(0.733-0.909)]and 0.939[95%CI(0.896-0.982)],respectively.The optimal cut-off values were 5.5 and 2.5 points,the sensitivity was 0.719 and 0.813,and the specificity was 0.813 and 0.933,respectively.Conclusion SAMe-TT_(2)R_(2)score has certain predictive value for TTR non-compliance in patients with persistent non valvular atrial fibrillation,while the CHA_(2)DS_(2)-VASc-60 stroke score has higher predictive value.