Additive prognostic value of left ventricular ejection fraction to the TIMI risk score for in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction

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• 作者：Xue-biao Wei ; Yuan-hui Liu ; Peng-cheng He…
• 关键词：Left ventricular ejection fraction (LVEF) ; Thrombolysis in myocardial infarction (TIMI) ; Mortality ; ST segment elevation myocardial infarction (STEMI)
• 刊名：Journal of Thrombosis and Thrombolysis
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：43
• 期：1
• 页码：1-6
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Cardiology; Hematology;
• 出版者：Springer US
• ISSN：1573-742X
• 卷排序：43

文摘

To investigate whether the addition of left ventricular ejection fraction (LVEF) to the TIMI risk score enhances the prediction of in-hospital and long-term death in ST segment elevation myocardial infarction (STEMI) patients. 673 patients with STEMI were divided into three groups based on TIMI risk score for STEMI: low-risk group (TIMI ≤3, n = 213), moderate-risk group (TIMI 4–6, n = 285), and high-risk group (TIMI ≥7, n = 175). The predictive value was evaluated using the receiver operating characteristic. Multivariate logistic regression was used to determine risk predictors. The rates of in-hospital death (0.5 vs 3.2 vs 10.3 %, p < 0.001) and major adverse cardiovascular events (14.6 vs 22.5 vs 40.6 %, p < 0.001) were significantly higher in high-risk group. Multivariate analysis showed that TIMI risk score (OR 1.24, 95 % CI 1.04–1.48, P = 0.015) and LVEF (OR 3.85, 95 % CI 1.58–10.43, P = 0.004) were independent predictors of in-hospital death. LVEF had good predictive value for in-hospital death (AUC: 0.838 vs 0.803, p = 0.571) or 1-year death (AUC: 0.743 vs 0.728, p = 0.775), which was similar to TIMI risk score. When compared with the TIMI risk score alone, the addition of LVEF was associated with significant improvements in predicting in-hospital (AUC: 0.854 vs 0.803, p = 0.033) or 1-year death (AUC: 0.763 vs 0.728, p = 0.016). The addition of LVEF to TIMI risk score enhanced net reclassification improvement (0.864 for in-hospital death, p < 0.001; 0.510 for 1-year death, p < 0.001). LVEF was associated with in-hospital and long-term mortality in STEMI patients and had additive prognostic value to TIMI risk score.