Prediction value of CHA2DS2-VASc score combined with D-dimer/fibrinogen ratio for spontaneous recanalization of acute ST-segment elevation myocardial infarction infarct-associated arteries
Prediction value of CHA2DS2-VASc score combined with D-dimer/fibrinogen ratio for spontaneous recanalization of acute ST-segment elevation myocardial infarction infarct-associated arteries
Objective To investigate the predictive value of CHA2DS2-VASc score combined with D-dimer(D-D)/fibrinogen(FIB)ratio(DFR)in infarct-associated spontaneous revascularization(IRA-SR)in acute ST segment elevation myocardial infarction(ASTEMI).Methods A total of 108 patients with ASTEMI from September 2021 to January 2023 were selected,all of whom underwent emergency coronary angiography and thromolytic therapy test for myocardial infarction(TIMI)after admission.TIMI grade 2 to 3 was included in the SR group(35 cases),and TIMI grade 0 to 1 was included in the non-SR group(73 cases).CHA2DS2-VASc score,DFR level and DFR level of patients with different CHA2DS2-VASc score were compared between the two groups,and the correlation between CHA2DS2-VASc score and DFR level and the predictive value of both on IRA-SR in ASTEMI patients were analyzed.Results There were significant differences in CHA2DS2-VASc scores between the two groups(P<0.05).The CHA2DS2-VASc score,D-D,FIB and DFR levels in SR group were lower than those in non-SR group(P<0.05).Patients with 1-2 CHA2DS2-VASc score in the SR group and non-SR group had D-D,FIB and DFR levels<3-4 points and above 4 points(P<0.05).The CHA2DS2-VASc score in both 2 groups was positively correlated with DFR(r=0.600,0.790,P<0.001).The AUC of IRA-SR predicted by CHA2DS2-VASc score and DFR were 0.832(95%CI 0.748-0.897)and 0.816(95%CI 0.730-0.884).According to the optimal cut-off value obtained in 2.4 ROC curve analysis,ASTEMI patients with CHA2DS2-VASc score and DFR level were divided into the higher and lower levels,and the likelihood of infarct-related artery SR of patients with the lower level was higher than that of patients with the higher level(P<0.05).CHA2DS2-VASc score combined with DFR predicted that the AUC of IRA-SR in ASTEMI patients was 0.907(95%CI 0.836-0.955),with the sensitivity of 71.43%and the specificity of 95.89%,which was better than the two predictions alone.Conclusion CHA2DS2-VASc score combined with DFR in predicting IRA-SR in ASTEMI patients is reliable and would provide guidance information for the clinical treatment planning.
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