心肌梗死溶栓治疗临床试验危险评分对急性心肌梗死患者远期预后的预测价值

 目的 探讨心肌梗死溶栓治疗临床试验(thrombolysis in myocardial infarction, TIMI)危险评分对急性心肌梗死(acute myocardial infarction, AMI)患者远期预后的预测价值。方法 采用回顾性分析,收集解放军总医院第三医学中心2014-01-01至2015-12-31收治并且出院后完成3年随访的AMI患者2958例。对每例患者进行TIMI危险评分,记录3年内发生终点事件的情况。结果 不同危险分层的患者3年内终点事件高危患者发生率为99.65%,高于中危患者(35.35%)和低危患者(13.71%),差异有统计学意义(P＜0.05)。不同危险分层的患者3年内病死率高危患者为19.96%,高于中危患者的5.33%和低危患者的1.31%,差异有统计学意义(P＜0.05)。 采用TIMI危险评分预测AMI患者3年内病死率,曲线下面积(area under the curve, AUC)为0.7996, 95%CI为0.7962～0.8030。结论 AMI患者的TIMI危险评分越高,随访3年内终点事件发生率越高,病死率越高,长期预后越差。TIMI危险评分体系是评估AMI患者近期及远期预后的有效工具。

Predictive value of TIMI risk scores for long-term prognosis in patients with acute myocardial infarction

Objective To investigate the predictive value of TIMI risk scores for thrombolytic therapy of myocardial infarction in patients with acute myocardial infarction.Methods The present data was obtained from a retrospective analysis. A total of 2958 cases of acute myocardial infarction treated in our hospital between January 1,2014 and December 31,2015 were selected, who completed 3 years of follow-up after discharge. The TIMI risk score was recorded of each patient to follow up on the endpoint events within 3 years.Results The incidence of endpoint events in patients with different risk stratification was compared. The incidence was 99.65% for the high score group, 35.35% for the middle score group, and 13.71% for the low score group, so the difference was statistically significant (P<0.05). The three-year mortality rate of patients with different risk stratification was compared: 19.96% for the high score group, 5.33% for the middle score group and 1.31% for the low score group. The difference was also of statistical significance (P<0.05).The AUC of the TIMI risk score was 0.7996, while 95%CI was 0.7962-0.8030.Conclusions The higher the TIMI risk score in AMI patients, the higher the incidence of endpoint events within 3 years of follow-up, the higher fatality rate and the worse long-term prognosis. TIMI risk scores can effectively help predict the prognosis in patients with AMI.