急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后Selvester QRS评分与主要不良心血管事件的相关性

Correlation between Selvester QRS Score and Major Adverse Cardiovascular Events in Patients with Acute ST-Segment Elevation Myocardial Infarction after Percutaneous Coronary Intervention

目的探讨急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后Selvester QRS评分与主要不良心血管事件(major adverse cardiovascular events,MACE)的相关性。方法选取2016年1月至2018年5月在昆明医科大学第二附属医院行PCI治疗的STEMI患者,根据有无MACE分为两组,随访3年,出院时计算Selvester QRS评分。结果本研究共纳入468例患者,其中116例(24.79%)发生MACE。MACE组患者Selvester QRS评分高于非MACE组,差异有统计学意义(P<0.01)。二元Logistic回归分析发现,Selvester QRS评分是STEMI患者MACE的独立预测因子(OR=1.235,95%CI:1.093~1.394,P=0.001)。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析评估Selvester QRS评分联合左心室射血分数(LVEF)的诊断价值灵敏度为69.5%,特异度为96.6%。进一步分析显示,相较于评分<6.5的患者,Selvester QRS评分≥6.5的患者MACE发生率更高(P<0.01)。结论Selvester QRS评分对STEMI患者MACE有较好的预测价值。

Objectives To investigate the correlation between Selvester QRS score and major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The STEMI patients undergoing PCI were consecutively enrolled from January 2016 to May 2018 in The Second Affiliated Hospital of Kunming Medical University.They were divided into groups according to with or without MACE and followed up for 3 years.The Selvester QRS score was calculated at discharge.Results Of all 468 patients included in this study,116(24.79%)developed MACE.The Selvester QRS score were higher in MACE group than that in non-MACE group(P<0.000).In a binary Logistic regression analysis,the Selvester QRS score(OR=1.235,95%CI:1.093-1.394,P=0.001)was found as an independent predictor of MACE in STEMI patients.Receiver operating characteristic curve(ROC)analysis evaluated that the diagnostic value of Selvester QRS score combined with left ventricular ejection fraction(LVEF)was with a sensitivity of 69.5% and a specificity of 96.6%.Further analysis showed that patients with Selvester QRS score≥6.5 had a higher incidence of MACE than patients with Selvester QRS score<6.5(P<0.01).Conclusions The Selvester QRS score has a good predictive value for MACE in STEMI patients undergoing PCI.