中华保健医学杂志2024,Vol.26Issue(5) :554-557.DOI:10.3969∕j.issn.1674-3245.2024.05.002

GRACE、TIMI评分对非ST段抬高型急性冠状动脉综合征患者不良心血管事件的评估价值

Assessment of the GRACE and TIMI scores for predicting adverse cardiovascular events in patients with non-ST-segment elevation acute coronary syndrome

汪金亮 聂婷 卢文婷 程媛媛
中华保健医学杂志2024,Vol.26Issue(5) :554-557.DOI:10.3969∕j.issn.1674-3245.2024.05.002

GRACE、TIMI评分对非ST段抬高型急性冠状动脉综合征患者不良心血管事件的评估价值

Assessment of the GRACE and TIMI scores for predicting adverse cardiovascular events in patients with non-ST-segment elevation acute coronary syndrome

汪金亮 1聂婷 2卢文婷 2程媛媛3
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作者信息

  • 1. 830000 乌鲁木齐,新疆维吾尔自治区人民医院门诊科
  • 2. 830000 乌鲁木齐,新疆维吾尔自治区人民医院心内科
  • 3. 西安医学院第三附属医院心内科
  • 折叠

摘要

目的 探讨全球急性冠状动脉事件注册(GRACE)评分、心肌梗死溶栓治疗(TIMI)评分对非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者不良心血管事件的评估价值.方法 回顾性收集 2020 年 1 月~2023 年 11 月新疆维吾尔自治区人民医院治疗的257 例NSTE-ACS患者的临床资料.根据GRACE和TIMI评分将患者分为低危组、中危组、高危组.统计患者发病30 d内不良心血管事件的发生情况,并对不同风险分层患者不良心血管事件的发生率进行比较,计算受试者工作特征(ROC)曲线的曲线下面积(AUC),评估GRACE、TIMI评分对NSTE-ACS患者不良心血管事件的评估价值.结果 TIMI评分系统的低危患者比例为 23.35%(60∕257),与GRACE评分系统的 18.68%(48∕257)比较,差异无统计学意义(P>0.05);TIMI评分系统的中危患者比例为 62.65%(161∕257),高于GRACE评分系统的 40.47%(104∕257);TIMI评分系统的高危患者比例为 14.00%(36∕257),低于GRACE评分系统的 40.86%(105∕257),差异均有统计学意义(t=25.308、48.101,P<0.05).两种评分系统不同分层患者不良心血管事件总发生率比较,差异有统计学意义(χ2=24.403,P<0.05);死亡率比较,差异无统计学意义(χ2=0.778,P>0.05).GRACE评分预测NSTE-ACS患者不良心血管事件的AUC为 0.756,高于TIMI评分的 0.603.结论 GRACE和TIMI风险评分对于NSTE-ACS患者近期心血管不良事件的发生均有一定的适用性,GRACE评分的预测价值更高.

Abstract

Objective To evaluate the predictive value of the Global Registry of Acute Coronary Events(GRACE)and Thrombolysis in Myocardial Infarction(TIMI)scores for adverse cardiovascular events in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS).Methods Clinical data of NSTE-ACS patients admitted from January 2020 to November 2023 were collected.Patients were categorized into low-risk,medium-risk,and high-risk groups based on GRACE and TIMI scores.The incidence of adverse cardiovascular events within 30 days of symptom onset was recorded.The incidence rates of adverse cardiovascular events across different risk strata were compared,and the area under the receiver operating characteristic(ROC)curve(AUC)was calculated to assess the predictive value of the GRACE and TIMI scores.Results The proportion of low-risk patients was not significantly different between the TIMI(23.35%,60∕257)and GRACE(18.68%,48∕257)scoring systems(P>0.05).The proportion of medium-risk patients was higher in the TIMI scoring system(62.65%,161∕257)compared to the GRACE system(40.47%,104∕257),while the proportion of high-risk patients was lower in the TIMI system(14.00%,36∕257)than in the GRACE system(40.86%,105∕257),with statistically significant differences(t=25.308,48.101,P<0.05).The overall incidence of adverse cardiovascular events differed significantly between the two scoring systems(χ2=24.403,P<0.05),but mortality rates did not(χ2=0.778,P>0.05).The AUC for the GRACE score in predicting adverse cardiovascular events was 0.756,which was higher than that of the TIMI score at 0.603.Conclusion Both the GRACE and TIMI risk scores are applicable for assessing the risk of adverse cardiovascular events in NSTE-ACS patients,with the GRACE score showing a higher predictive value.

关键词

全球急性冠状动脉事件注册评分/心肌梗死溶栓治疗评分/非ST段抬高型急性冠脉综合征/不良心血管事件/预测价值

Key words

Global registry of acute coronary events score/Thrombolysis in myocardial infarction score/Non-ST-segment elevation acute coronary syndrome/Adverse cardiovascular events/Predictive value

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基金项目

新疆维吾尔自治区自然科学基金面上项目(20210258)

出版年

2024
中华保健医学杂志
中国人民解放军总后勤部卫生部保健局

中华保健医学杂志

CSTPCD
影响因子:0.477
ISSN:1674-3245
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