| 夏林虎,魏腾飞,涂胜,等.冠状动脉树描述和病变评估对急诊经皮冠状动脉介入治疗的 STEMI病人住院期间新发心房颤动的预测价值[J].安徽医药,2026,30(1):107-112. |
| 冠状动脉树描述和病变评估对急诊经皮冠状动脉介入治疗的 STEMI病人住院期间新发心房颤动的预测价值 |
| The predictive value of the coronary artery tree description and lesion evaluation score for new-onset atrial fibrillation in STEMl patients undergoing emergency percutaneous coronary intervention during hospitalization |
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| DOI：10.3969/j.issn.1009-6469.2026.01.022 |
| 中文关键词: ST段抬高型心肌梗死 冠状动脉树描述和病变评估( CatLet) 心房颤动 经皮冠状动脉内介入治疗 肌钙蛋白 I 预测价值 |
| 英文关键词: ST elevation myocardial infarction Coronary artery tree description and lesion evaluation (CatLet) Atrial fibrillation Percutaneous coronary intervention Troponin I Predictive value |
| 基金项目:安徽高校自然科学研究重点项目( KJ2020A0336) |
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| 中文摘要: |
| 目的分析冠状动脉树描述和病变评估( CatLet)评分在急诊经皮冠状动脉介入治疗( PCI)的急性 ST段抬高型心肌梗死(STEMI)病人住院期间新发心房颤动( NOAF)的预测价值。方法连续入选 2021年 1月至 2023年 3月于亳州市人民医院行经皮冠状动脉介入治疗的 STEMI病人 396例，根据术中 CatLet评分分为高分组 ≥25分( 192例)，低分组 <25分( 204例)；分析两组基线资料及住院期间 NOAF发病率差异，应用二元 logistic回归分析 STEMI病人住院期间 NOAF的危险因素，绘制受试者操作特征曲线( ROC曲线)评估 CatLet评分对 STEMI病人住院期间 NOAF的预测价值。结果 396例 STEMI住院病人 NOAF45例(11.4%)； CatLet高分组 38例，低分组 7例( 19.8%比 3.4%，P<0.001)。与低分组相比，高分组在 KillipⅡ~Ⅳ级比例、 N末端 B型脑钠肽前体( NT-ProBNP)水平、肌钙蛋白 I(CtnI)值、多支血管病变例数、慢/无复流比例明显升高，左心室射血分数( LVEF)值明显降低( P<0.001)；经二元 logistic回归分析显示: CatLet评分、年龄、 Killip分级、左心房内径( LAD)、多支血管病变( 3支冠状动脉血管中至少有 2支血管存在狭窄且程度 ≥50%)、冠状动脉病变的复杂性及严重程度( Syntax)评分是 STEMI病人住院期间出现 NOAF的独立危险因素； CatLet评分预测 STEMI病人住院期间 NOAF的曲线下面积( AUC)为 0.78，灵敏度 93.3%，特异度 52.4%。结论 CatLet评分、年龄、 Killip分级、左心房内径、多支血管病变、 Syntax评分是 STEMI病人住院期间出现 NOAF的独立危险因素， CatLet评分对 STEMI病人住院期间 NOAF有一定的预测价值。 |
| 英文摘要: |
| Objective To analyze the predictive value of the coronary artery tree description and lesion evaluation (CatLet) score in new-onset atrial fibrillation (NOAF) during hospitalization in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI).Methods A total of 396 patients with STEMI who underwent emer-gency PCI from January 2021 to March 2023 were enrolled in the study. They were assigned to a high-score group (≥25 points, 192 cas-es) or a low-score group (<25 points, 204 cases) according to the CatLet score during the operation. The differences in baseline data andthe incidence of NOAF during hospitalization between the two groups were analyzed. Binary Logistic regression was used to analyze therisk factors for NOAF during hospitalization in STEMI patients, and ROC curve was drawn to evaluate the predictive value of the Cat.Let score for NOAF during hospitalization in STEMI patients.Results Among the 396 inpatients with STEMI, 45 (11.4%) had NOAF, including 38 in the high-score group and 7 in the low-score group (19.8% vs. 3.4%, P < 0.001). Compared with the low-score group, the high-score group had a significantly higher proportion of Killip grade Ⅱ-Ⅳ, N-terminal pro-B-type natriuretic peptide (NT-ProBNP) level, cardiac troponin I (CtnI) value, number of multi-vessel lesions, and proportion of slow/no-reflow, and a significantly lower left ven-tricular ejection fraction (LVEF) value (P < 0.001). Binary Logistic regression analysis results showed that CatLet score, age, Killip clas-sification, left atrial diameter (LAD), multi-vessel lesions (stenosis of ≥50% in at least two of the three major coronary arteries), and Syn-tax score (grading system for quantifying the complexity and severity of coronary artery disease) were independent risk factors for in-hos-pital NOAF in patients with STEMI. The area under the curve (AUC) of the CatLet score in predicting in-hospital NOAF in patients with STEMI was 0.78, with a sensitivity of 93.3% and a specificity of 52.4%.Conclusion The CatLet score, age, Killip classification, LAD, multi-vessel lesions, and Syntax score are independent risk factors for in-hospital NOAF in patients with STEMI, and the CatLet score has certain predictive value for NOAF in patients with STEMI during hospitalization. |
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