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Abstract
Introduction: Acute coronary syndrome (ACS) is still the leading cause of mortality worldwide. Percutaneous coronary intervention (PCI) was appeared as a modern treatment method, considered as a priority for coronary artery revascularization, which significantly improved mortality in patients with acute coronary syndrome. The RISKPCI score is a new, easy - to - use and includes many clinical factors and intervention parameters that can predict Major Adverse Cardiovascular Events (MACE) and mortality in patients with acute coronary syndromes after percutaneous coronary intervention. Therefore, we carried out this study with two objectives: To figure out the clinical and subclinical characteristics of patients with acute coronary syndrome undergoing percutaneous coronary intervention and to evaluate the RISK-PCI score in predicting Major Adverse Cardiovascular Events in 12 months post - intervention in patients with acute coronary syndrome.
Methods: Cross - sectional descriptive and prospective study in 337 acute coronary syndrome patients who received percutaneous coronary intervention at the Department of Emergency - Interventional Cardiology - Hue Central Hospital since January 2021 - December 2021 and follow - up 12 months after the intervention.
Results: The mean age was 68.19 ± 10.73, and the male/female ratio was approximately 2/1. ST - elevation Myocardial Infarction accounted for the majority with 56.4%, Non - ST - Elevation Myocardial Infarction and Unstable Angina made up 27.3% and 16.3%, respectively. The rate of MACE within 12 months after intervention was 3.6%. The Area under the curve (AUC) of the RISK PCI predicting all-cause mortality in ACS was 0.928, the cut - off point was 5.25, with the sensitivity of 100%, and the specificity of 75.1%. The Kaplan - Meier plot showed early and sustained survival separated during 12 months of follow-up between the very high - risk and other RISK-PCI scores (p < 0.0001). Conclusion: The RISK-PCI score in predicting MACE events after 12 months of follow - up in ACS patients undergoing PCI had a good value (AUC = 0.928, 95% CI 0.878 - 0.978, p < 0.001). High - and very - high - risk patients who had a poor prognosis and required optimal medical and rehabilitation treatment, close follow - up, and complete revascularization should be considered prior to being discharged from the hospital.
References
WHO. Global health estimates 2016: deaths by cause, age,
sex, by country and by region 2000-2016. 2018.
Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal
Definition of Myocardial Infarction (2018). Circulation.
;138(20):e618-e651.
Zijlstra F, Hoorntje JC, de Boer MJ, et al. Long-term benefit
of primary angioplasty as compared with thrombolytic
therapy for acute myocardial infarction. N Engl J Med.
;341(19):1413-9.
Mandelzweig L, Battler A, Boyko V, et al. The second
Euro Heart Survey on acute coronary syndromes:
Characteristics, treatment, and outcome of patients with
ACS in Europe and the Mediterranean Basin in 2004. Eur
Heart J. 2006;27(19):2285-93.
Mrdovic I, Savic L, Lasica R, et al. Usefulness of the RISKPCI score to predict stent thrombosis in patients treated
with primary percutaneous coronary intervention for STsegment elevation myocardial infarction: a substudy of the
RISK-PCI trial. Heart and Vessels. 2013;28(4):424-433.
Savic L, Mrdovic I, Asanin M, et al. Using the RISKPCI Score in the Long-Term Prediction of Major Adverse
Cardiovascular Events and Mortality after Primary
Percutaneous Coronary Intervention. J Interv Cardiol.
;2019:2679791.
Thoa GT, Nghiên cứu nồng độ H-FABP trong chẩn đoán và
tiên lượng nhồi máu cơ tim cấp. 2018, Trường Đại học Y
Dược Huế.
Hải NH, Nghiên cứu vai trò của acid uric trong tiên lượng
hội chứng mạch vành cấp,. 2019, Đại Học Y Dược Thành
Phố Hồ Chí Minh.
Long B, Nghiên cứu kết quả điều trị can thiệp bệnh nhân
hội chứng động mạch vành cấp bằng Stent phủ thuốc có
Polymer tự tiêu. 2018, Học Viện Quân Y.
Linh NV, Đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân
HCMVC được PCI tại Bệnh Viện Đa Khoa Trung Ương
Thái Nguyên. 2015, Trường Đại Học Y Dược Thái Nguyên.
Phạm Nguyễn Vinh, Việt NL. Nghiên Cứu Quan Sát Điều
Trị Bệnh Nhân Nhập Viện Do Hội Chứng Động Mạch
Vành Cấp (MEDI- ACS Study). Tim mạch học Việt Nam.
;58:12-23.
Hùng TP, Giá trị của NGAL trong tiên đoán các biến cố tim
mạch ở bệnh nhân hội chứng mạch vành cấp. 2019, Trường
Đại Học Dược Tp Hồ Chí Minh.
Jakimov T, Mrdović I, Filipović B, et al. Comparison of
RISK-PCI, GRACE, TIMI risk scores for prediction of
major adverse cardiac events in patients with acute coronary
syndrome. Croat Med J. 2017;58(6):406-415.
Tuấn PQ, Nghiên cứu vai trò chẩn đoán của IMA (Ischemia
Modified Albumin) huyết thanh phối hợp với hs-troponin t
ở bệnh nhân hội chứng vành cấp. 2019, Trường Đại học Y
Dược Huế.
Ranucci M, Aloisio T, Di Dedda U, et al. Gender-based
differences in platelet function and platelet reactivity to
P2Y12 inhibitors. PLoS One. 2019;14(11):e0225771.
Fujii T, Suzuki T, Torii S, et al. Diagnostic accuracy of
Global Registry of Acute Coronary Events (GRACE)
risk score in ST-elevation myocardial infarction for inhospital and 360-day mortality in Japanese patients. Circ J.
;78(12):2950-4.
Tuấn NQ, Nghiên cứu hiệu quả của phương pháp can thiệp
động mạch qua da trong điều trị nhồi máu cơ tim cấp. 2005,
Đại học Y Hà Nội.
Đoàn Văn Chung, Hoàng Anh Tiến, Bình HA. Nghiên cứu
mối liên quan của nồng độ BNP huyết thanh và Hs cTnI với
biến cố tái nhập viện sau can thiệp động mạch vành. Tạp chí
Nội tiết và Đái tháo đường. 2020:62-72.
| Published | 20-08-2023 | |
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| Issue | No. 89 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.89.13 | |
| Keywords | Hội chứng vành cấp, biến cố tim mạch chính, can thiệp động mạch vành qua da, thang điểm RISK-PCI Acute coronary syndrome, Major Adverse Cardiovascular Event, Percutaneous coronary intervention, RISK-PCI score |
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