MedElevator
Войти в исследования Journal of electrocardiology · 2026
Identifying the electrically unstable NSTEMI patient: Comparative performance of four scores for short-term risk stratification of major cardiac arrhythmias.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hsiao Hung Yu, Kuo Shu-Cheng, Hou Sen-Kuang, Lin Sheng-Feng, Lin Hui-An
Аннотация
BACKGROUND: Major cardiac arrhythmias after NSTEMI are associated with increased mortality and adverse clinical outcomes. However, evidence comparing the ability of established acute coronary syndrome risk scores to predict in-hospital arrhythmic events remains limited.
METHODS: We conducted a retrospective cohort study of consecutive NSTEMI patients who underwent coronary angiography at Taipei Medical University Hospital between January 2017 and August 2022. Major cardiac arrhythmias were defined as ventricular tachycardia, ventricular fibrillation, new-onset atrial fibrillation, and high-degree atrioventricular block occurring during hospitalization. Clinical characteristics, laboratory findings, electrocardiographic features, and angiographic data were analyzed. The discriminatory performance of TIMI, HEART, GRACE 2.0, T-MACS, and an integrated multivariable model was evaluated using ROC analysis.
RESULTS: A total of 485 patients were included, among whom 55 (11.3%) developed major cardiac arrhythmias during hospitalization. Patients with arrhythmias had significantly higher rates of prior heart failure, AKI, and RBBB. Multivariable logistic regression identified heart failure (OR 3.663, p < 0.001), RBBB (OR 2.611, p = 0.030), AKI (OR 2.102, p = 0.045), and higher serum sodium levels (OR 1.079, p = 0.012) as independent predictors of arrhythmic events. The integrated prediction model demonstrated higher observed discrimination for major cardiac arrhythmias (AUC 0.733, p < 0.001) compared with conventional ACS scoring systems. In contrast, the GRACE 2.0 score showed the most consistent performance for predicting in-hospital mortality.
CONCLUSION: In NSTEMI patients, an exploratory model incorporating heart failure, AKI, RBBB, and serum sodium showed discriminatory ability for major cardiac arrhythmias. Meanwhile, the GRACE 2.0 score remained the most reliable tool for mortality prediction, supporting its continued role in global prognostic assessment of NSTEMI patients.
METHODS: We conducted a retrospective cohort study of consecutive NSTEMI patients who underwent coronary angiography at Taipei Medical University Hospital between January 2017 and August 2022. Major cardiac arrhythmias were defined as ventricular tachycardia, ventricular fibrillation, new-onset atrial fibrillation, and high-degree atrioventricular block occurring during hospitalization. Clinical characteristics, laboratory findings, electrocardiographic features, and angiographic data were analyzed. The discriminatory performance of TIMI, HEART, GRACE 2.0, T-MACS, and an integrated multivariable model was evaluated using ROC analysis.
RESULTS: A total of 485 patients were included, among whom 55 (11.3%) developed major cardiac arrhythmias during hospitalization. Patients with arrhythmias had significantly higher rates of prior heart failure, AKI, and RBBB. Multivariable logistic regression identified heart failure (OR 3.663, p < 0.001), RBBB (OR 2.611, p = 0.030), AKI (OR 2.102, p = 0.045), and higher serum sodium levels (OR 1.079, p = 0.012) as independent predictors of arrhythmic events. The integrated prediction model demonstrated higher observed discrimination for major cardiac arrhythmias (AUC 0.733, p < 0.001) compared with conventional ACS scoring systems. In contrast, the GRACE 2.0 score showed the most consistent performance for predicting in-hospital mortality.
CONCLUSION: In NSTEMI patients, an exploratory model incorporating heart failure, AKI, RBBB, and serum sodium showed discriminatory ability for major cardiac arrhythmias. Meanwhile, the GRACE 2.0 score remained the most reliable tool for mortality prediction, supporting its continued role in global prognostic assessment of NSTEMI patients.