The value of electro-mechanical activation time ratio in predicting the major adverse events in hospitalized patients / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the value of adjusted electro-mechanical activation time ratio (EMAT％) in predicting the major adverse events occurred in hospitalized patients with cardiovascular diseases.Methods A cohort of 453 patients aged ＞ 18 years with cardiovascular diseases were consecutively enrolled from January 1st 2016 to August 1st 2016.The data of EMAT％ were documented three times in the first 24 hours after admission,and at the same time,B type natriuretic peptide,left ventricle ejection fraction and troponin I were recorded.The exclusion criteria were valvular heart diseases,congenital heart diseases,the pregnant and perinatal women,and the patients with untreated cancer.The major adverse events were defined to be cardiogenic death,onset of acute heart failure,cardiogenic shock,myocardial infarction,ventricular tachycardia/fibrillation,and heart arrest.There were 25 patients suffering from major adverse events and 428 patients without any form of adverse events.Multivariate logistic regression analysis was used to determine the association between adjusted electro-mechanical activation time ratio (EMAT％) and major adverse events.The predictive value was established by receiver operating characteristic curve.Results From this trial,elevated EMAT％ was proved to be the independent riskfactor (EMAT％ OR =1.444,95％ CI1.201-1.736,P ＜ O.05) for the occurrence of major adverse events in patients with cardiovascular diseases admitted in hospital,and BNP ＞ 200 pg/mL was independent risk factor too.The area under the curve of EMAT％ was 0.887 (95％ CI0.812-0.962,P ＜ 0.05),Youden index 0.653,the sensibility of predicting the end point of major adverse events was 0.840 when the optimal cutoff point was set at EMAT％ ＞ 11.5 ％ and the specificity was 0.813.Conclusion The elevated EMAT％ is found to be the independent risk factor for predicting the onset of major adverse events in patients with cardiovascular diseases admitted in hospital,and it can be used to identify the critical patients.