RESUMO
Objective: To establish a scoring system for predicting the risk of side branch occlusion(SBO) in coronary bifurcation intervention based on visual estimation of quantitative coronary angiography (QCA). Methods: RESOLVE scoring system was developed from QCA. A total of 1545 patients with 1601 bifurcation lesions by RESOLVE study were enrolled. Based on RESOLVE scoring system, visual estimation was conducted to compare the consistency. According to SBO occurrence after main branch stent implantation, our research was divided into 2 groups: SBO group, which was defined by coronary angiography confirmed TIMI grade decreasing, n=114 patients with 118 lesions and Non-SBO group, n=1431 patients with 1483 lesions. Using RESOLVE scoring method as reference,V-RESOLVE scoring system was established, the discrimination, goodness-of-fit and V-RESOLVE score for the incidence of SBO were assessed;the diagnostic value for predicting the risk of SBO in coronary bifurcation intervention was compared between 2 scoring systems. Results: The consistency between visual and QCA was from fair to moderate (weighted Kappa=0.22-0.44). Compared with Non-SBO group, SBO group had the higher degrees of pre-operative bifurcation stenosis and side branch stenosis before main branch stent implantation; larger bifurcation angle and vessel diameters in main/side branches, all P<0.01. The area of V-RESOLVE under ROC curve was 0.76(95%CI 0.71-0.81) which was similar to the area of RESOLVE under ROC curve:0.77 (95% CI 0.72-0.81), P=0.74, Hosmer-Lemeshow P=0.17. The patients were categorized into 2 conditions by V-RESOLVE: high risk (V-RESOLVE score≥12)and non-high risk (V-RESOLVE score<12), the incidence of SBO was higher in high risk patients (16.7% vs 4.3%), P<0.01. The incidences of SBO were similar in non-high risk patients by V-RESOLVE and RESOLVE (4.3% vs 3.4%), P=0.22 and in high risk patients (16.7% vs 18.0%), P=0.60. Conclusion: V-RESOLVE scoring system may predict the risk of SBO in patients with coronary bifurcation intervention.
RESUMO
Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.
RESUMO
Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.