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The Predictive Value of Baseline Target Lesion SYNTAX Score for No-Reflow during Urgent Percutaneous Coronary Intervention in Acute Myocardial Infarction
Journal of Interventional Cardiology ( IF 2.1 ) Pub Date : 2021-08-04 , DOI: 10.1155/2021/9987265
Guofeng Gao 1 , Han Xu 1 , Dong Zhang 1 , Chenxi Song 1 , Changdong Guan 1 , Bo Xu 1 , Dong Yin 1 , Kefei Dou 1
Affiliation  

Objectives. To evaluate the predictive value of target lesion SYNTAX score (TL-SS) for no-reflow in the patients with acute myocardial infarction undergoing urgent percutaneous coronary intervention (PCI). Background. Risk assessment, prevention, and prompt management of no-reflow in urgent PCI are crucial but remain challenging. SYNTAX score emerged as a tool for prediction, but may contain redundant information. Methods. After screening of consecutive patients who underwent urgent PCI in Fuwai Hospital from January 2013 to December 2013, 487 patients with 528 lesions were involved. The endpoint was no-reflow during the PCI procedure. Results. No-reflow occurred in 52 patients (10.7%) and 53 lesions (10.0%). High TL-SS levels were strongly associated with increased risks of no-reflow in the urgent PCI procedure (all adjusted ). TL-SS displayed good discrimination ability for no-reflow (C-statistics = 0.76, 95% CI 0.72–0.80), which was better than that of SYNTAX score (). Following categorizing the lesions into two groups according to the Youden Index, the high-risk group (TL-SS ≥8) showed significantly higher no-reflow rate compared with the low-risk group (TL-SS <8) (20.6% vs. 3.6%, odds ratio 6.86, 95% confidence interval 3.50–13.41, ). In the target lesions that underwent balloon predilation, maximum predilation pressure >10 atm was associated with higher rate of no-reflow in the high-risk group (odds ratio 3.81, 95% confidence interval 1.10–13.17). Conclusions. TL-SS is a potential predictor for risk stratification of no-reflow in urgent PCI. In the high TL-SS lesions that underwent balloon predilation, maximum predilation pressure >10 atm was associated with higher risk of no-reflow.

中文翻译:

急性心肌梗死紧急经皮冠状动脉介入治疗中基线靶病变SYNTAX评分对无复流的预测价值

目标。评价靶病灶SYNTAX评分(TL-SS)对急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)患者无复流的预测价值。背景。紧急 PCI 中无复流的风险评估、预防和及时管理至关重要,但仍然具有挑战性。SYNTAX 分数作为预测工具出现,但可能包含冗余信息。方法。筛选2013年1月至2013年12月在阜外医院接受急诊PCI的连续患者,共纳入487例患者528个病灶。PCI 过程中的终点是无复流。结果. 52 名患者 (10.7%) 和 53 个病灶 (10.0%) 发生无复流。高 TL-SS 水平与紧急 PCI 程序中无复流风险增加密切相关(所有调整)。TL-SS 对无回流表现出良好的辨别能力(C-statistics = 0.76, 95% CI 0.72–0.80),优于 SYNTAX 评分()。根据约登指数将病变分为两组后,高危组(TL-SS ≥8)的无复流率显着高于低危组(TL-SS <8)(20.6% vs . 3.6%,优势比 6.86,95% 置信区间 3.50–13.41,)。在接受球囊预扩张的目标病灶中,最大预扩张压力 > 10 atm 与高风险组较高的无复流率相关(优势比 3.81,95% 置信区间 1.10-13.17)。结论。TL-SS 是紧急 PCI 中无复流风险分层的潜在预测因子。在接受球囊预扩张的高 TL-SS 病变中,最大预扩张压力 > 10 atm 与较高的无复流风险相关。
更新日期:2021-08-04
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