Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardia...Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardial infarction(TIMI)score and clinical prognosis.Method:The study was a retrospective one-center observational study,continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data,laboratory examination results,imaging data and interventional treatment data of all patients.Were divided into:T2DM with ACS group(group DA)and non-T2DM with ACS(group NDA)according to whether or not they were associated with T2DM.According to the GRACE、TIMI score,the two groups were divided into high risk group,middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores.Design questionnaire,after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months,statistics of the occurrence of MACE events.Result:Among the 600 patients included in the study,362 were male(60.3%)and 238 were female(39.7%)with mean age(64.7±10.3)years.The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group;the proportion of men was lower than in the NDA group.The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group,and the proportion of single lesion was lower than that of NDA group.The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM.GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,and there was no significant difference between low and middle risk group.TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,while the proportion of low and middle risk group was lower than that in NDA group.The ROC curve shows that the area(AUC)below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586.Conclusion:Patients with T2DM and ACS had higher clinical risk stratification than without T2DM.GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.展开更多
To test whether circulating and intracoronary biomarkers and coronary plaque strain have additive values to Global Registry of Acute Coronary Events(GRACE) score for predicting long-term cardiovascular events in ACS p...To test whether circulating and intracoronary biomarkers and coronary plaque strain have additive values to Global Registry of Acute Coronary Events(GRACE) score for predicting long-term cardiovascular events in ACS patients. One hundred ACS patients were enrolled and the GRACE score and plasma levels and intracoronary gradients of a number of biomarkers were measured. Coronary plaque burden and morphology in non-critical stenotic plaques were determined by intravascular ultrasound(IVUS) technique, and the maximal shear strain(SSmax) and maximal area strain(ASmax) were determined by intravascular ultrasound elastography(IVUSE) technique. Patients were followed for cardiovascular events and the predictive values of clinical characteristics, plasma biomarkers and plaque parameters were compared with GRACE score, and the incremental values of these measurements to the GRACE score were assessed. GRACE score, plasma biomarkers and plaque strain were independent predictors of cardiovascular events. Combination of GRACE score, plasma biomarkers and plaque strains significantly improved the predictive value of the GRACE score alone with the receiver-operating characteristic area increased from0.457 to 0.667(P=0.014). The combination of circulating and intracoronary biomarkers, plaque strain and GRACE score provides a better predictive tool than GRACE score alone in patients with ACS.展开更多
Background ST-elevated myocardial infarction(STEMI) is a common type of acute myocardial infarction with high morbidity, disability and mortality, which seriously threatens the life and health of patients. Percutaneou...Background ST-elevated myocardial infarction(STEMI) is a common type of acute myocardial infarction with high morbidity, disability and mortality, which seriously threatens the life and health of patients. Percutaneous coronary intervention(PCI) is the preferred treatment for STEMI, which can quickly open blocked coronary arteries and restore myocardial blood perfusion, thus significantly improving the clinical symptoms and prognosis of patients. However, in clinical practice, STEMI patients still face a series of adverse events after PCI, major adverse cardiovascular events(MACEs) are predominant. Therefore, in order to accurately evaluate the short-term MACE after PCI in STEMI patients, it is particularly important to explore more sensitive and specific predictors. Methods Clinical data of 150 STEMI patients admitted to our hospital from June 2021 to May 2024 were retrospectively analyzed, and they were divided into MACEs group(n=42) and non-MACEs group(n=108) according to whether they developed MACEs within 6 months after PCI. The predictive values of highly sensitive C-reactive protein(hs-CRP), N-terminal pro-B-type natriuretic peptide(NT-pro-BNP), the Global Registry of Acute Coronary Events(GRACE) score and synthetic analysis for short-term MACEs after PCI in STEMI patients were respectively analyzed. Either GRACE score >140, hs-CRP level >3 mg/m L or NT-pro-BNP level >1000 pg/m L was considered positive. Synthetic analysis was defined as positive when at least two of the above indicators were positive. Multivariable logistic regression and receiver operation characteristic(ROC) analysis were applied to analyze prognostic values of hs-CR, NT-pro-BNP,GRACE score and synthetic analysis respectively for short-term MACEs after PCI in STEMI patients. Results The level of hs-CRP, NT-pro-BNP and GRACE score in MACEs group were higher than non-MACEs group(P<0.05). Logistic regression analysis showed that hs-CRP, NT-proBNP and GRACE score were all independent risk factors for short-term MACEs after PCI in STEMI patients. Synthetic analysis of hs-CRP, NT-pro-BNP and GRACE score showed the best predictive capacity for the occurrence of short-term MACEs than any single indicator with the highest area under curve(AUC) of 0.882, sensitivity of 97.62% and specificity of 95.33%. Conclusions Synthetic analysis of hs-CRP, NT-pro-BNP and GRACE score showed the best predictive capacity for the occurrence of short-term MACEs in STEMI patients after PCI.展开更多
基金512 Talent Culture Planning(No.by51201317,by51201105)Innovation Team of Basic and Clinical Application for Cardiovascular Injury and Protection(No.BYKC201906)+1 种基金Technology and Science Innovation Team of Bengbu Medical College(No.BYJC201901)Natural Science Research Key Programm of Bengbu Medical College(No.2020byzd109)。
文摘Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardial infarction(TIMI)score and clinical prognosis.Method:The study was a retrospective one-center observational study,continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data,laboratory examination results,imaging data and interventional treatment data of all patients.Were divided into:T2DM with ACS group(group DA)and non-T2DM with ACS(group NDA)according to whether or not they were associated with T2DM.According to the GRACE、TIMI score,the two groups were divided into high risk group,middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores.Design questionnaire,after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months,statistics of the occurrence of MACE events.Result:Among the 600 patients included in the study,362 were male(60.3%)and 238 were female(39.7%)with mean age(64.7±10.3)years.The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group;the proportion of men was lower than in the NDA group.The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group,and the proportion of single lesion was lower than that of NDA group.The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM.GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,and there was no significant difference between low and middle risk group.TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,while the proportion of low and middle risk group was lower than that in NDA group.The ROC curve shows that the area(AUC)below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586.Conclusion:Patients with T2DM and ACS had higher clinical risk stratification than without T2DM.GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.
基金supported by the Program of Introducing Talents of Discipline to Universities(B07035)the State Key Program of National Natural Science of China(81530014)+1 种基金the grants of the National Natural Science Foundation of China(81425004,81770442,81570324)the Taishan Scholars Program of Shandong Province,China(Zhang Cheng)。
文摘To test whether circulating and intracoronary biomarkers and coronary plaque strain have additive values to Global Registry of Acute Coronary Events(GRACE) score for predicting long-term cardiovascular events in ACS patients. One hundred ACS patients were enrolled and the GRACE score and plasma levels and intracoronary gradients of a number of biomarkers were measured. Coronary plaque burden and morphology in non-critical stenotic plaques were determined by intravascular ultrasound(IVUS) technique, and the maximal shear strain(SSmax) and maximal area strain(ASmax) were determined by intravascular ultrasound elastography(IVUSE) technique. Patients were followed for cardiovascular events and the predictive values of clinical characteristics, plasma biomarkers and plaque parameters were compared with GRACE score, and the incremental values of these measurements to the GRACE score were assessed. GRACE score, plasma biomarkers and plaque strain were independent predictors of cardiovascular events. Combination of GRACE score, plasma biomarkers and plaque strains significantly improved the predictive value of the GRACE score alone with the receiver-operating characteristic area increased from0.457 to 0.667(P=0.014). The combination of circulating and intracoronary biomarkers, plaque strain and GRACE score provides a better predictive tool than GRACE score alone in patients with ACS.
文摘Background ST-elevated myocardial infarction(STEMI) is a common type of acute myocardial infarction with high morbidity, disability and mortality, which seriously threatens the life and health of patients. Percutaneous coronary intervention(PCI) is the preferred treatment for STEMI, which can quickly open blocked coronary arteries and restore myocardial blood perfusion, thus significantly improving the clinical symptoms and prognosis of patients. However, in clinical practice, STEMI patients still face a series of adverse events after PCI, major adverse cardiovascular events(MACEs) are predominant. Therefore, in order to accurately evaluate the short-term MACE after PCI in STEMI patients, it is particularly important to explore more sensitive and specific predictors. Methods Clinical data of 150 STEMI patients admitted to our hospital from June 2021 to May 2024 were retrospectively analyzed, and they were divided into MACEs group(n=42) and non-MACEs group(n=108) according to whether they developed MACEs within 6 months after PCI. The predictive values of highly sensitive C-reactive protein(hs-CRP), N-terminal pro-B-type natriuretic peptide(NT-pro-BNP), the Global Registry of Acute Coronary Events(GRACE) score and synthetic analysis for short-term MACEs after PCI in STEMI patients were respectively analyzed. Either GRACE score >140, hs-CRP level >3 mg/m L or NT-pro-BNP level >1000 pg/m L was considered positive. Synthetic analysis was defined as positive when at least two of the above indicators were positive. Multivariable logistic regression and receiver operation characteristic(ROC) analysis were applied to analyze prognostic values of hs-CR, NT-pro-BNP,GRACE score and synthetic analysis respectively for short-term MACEs after PCI in STEMI patients. Results The level of hs-CRP, NT-pro-BNP and GRACE score in MACEs group were higher than non-MACEs group(P<0.05). Logistic regression analysis showed that hs-CRP, NT-proBNP and GRACE score were all independent risk factors for short-term MACEs after PCI in STEMI patients. Synthetic analysis of hs-CRP, NT-pro-BNP and GRACE score showed the best predictive capacity for the occurrence of short-term MACEs than any single indicator with the highest area under curve(AUC) of 0.882, sensitivity of 97.62% and specificity of 95.33%. Conclusions Synthetic analysis of hs-CRP, NT-pro-BNP and GRACE score showed the best predictive capacity for the occurrence of short-term MACEs in STEMI patients after PCI.
