CAMI-NSTEMI Score - China Acute Myocardial Infarction Registry-Derived Novel Tool to Predict In-Hospital Death in Non-ST Segment Elevation Myocardial Infarction Patients -
CAMI-NSTEMI Score - China Acute Myocardial Infarction Registry-Derived Novel Tool to Predict In-Hospital Death in Non-ST Segment Elevation Myocardial Infarction Patients -
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DOI：
10.1253/circj.cj-17-1078
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发表时间：
2018-07-01
影响因子：
3.3
通讯作者：
Yang, Yuejin
中科院分区：
文献类型：
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作者：
Fu, Rui;Song, Chenxi;Yang, Yuejin
背景资料：非ST段抬高型心肌梗死（NSTEMI）患者的准确危险分层是重要的，因为死亡风险的变异性很大，但迄今为止，没有预测模型。因此，本研究的目的是建立一个风险评分，以预测在医院的死亡风险NSTEMI patients.Methods和结果：我们纳入了5,775例诊断为NSTEMI从中国急性心肌梗死（CAMI）登记和提取相关数据。患者被分为推导队列（n= 4，332）以开发多变量逻辑回归风险预测模型，以及验证队列（n= 1，443）以测试模型。11个变量独立预测住院死亡率，并纳入模型：年龄，体重指数，收缩压，Killip分级，心脏骤停，心电图ST段压低，血清肌酐，白色血细胞，吸烟状况，既往心绞痛和既往经皮冠状动脉介入治疗。在推导队列中，CAMI-NSTEMI风险模型和评分的曲线下面积（AUC）分别为0.81和0.79。在验证队列中，评分也显示出良好的区分度（AUC，0.86）。CAMI-NSTEMI风险评分的诊断性能上级GRACE风险评分（AUC，0.81 vs. 0.72; P
Background: Accurate risk stratification of non-ST segment elevation myocardial infarction (NSTEMI) patients is important due to great variability in mortality risk, but, to date, no prediction model has been available. The aim of this study was therefore to establish a risk score to predict in-hospital mortality risk in NSTEMI patients.Methods and Results: We enrolled 5,775 patients diagnosed with NSTEMI from the China Acute Myocardial Infarction (CAMI) registry and extracted relevant data. Patients were divided into a derivation cohort (n=4,332) to develop a multivariable logistic regression risk prediction model, and a validation cohort (n=1,443) to test the model. Eleven variables independently predicted in-hospital mortality and were included in the model: age, body mass index, systolic blood pressure, Killip classification, cardiac arrest, electrocardiogram ST-segment depression, serum creatinine, white blood cells, smoking status, previous angina, and previous percutaneous coronary intervention. In the derivation cohort, the area under curve (AUC) for the CAMI-NSTEMI risk model and score was 0.81 and 0.79, respectively. In the validation cohort, the score also showed good discrimination (AUC, 0.86). Diagnostic performance of CAMI-NSTEMI risk score was superior to that of the GRACE risk score (AUC, 0.81 vs. 0.72; P