高Glasgow预后评分与急性冠脉综合征患者的全因死亡率和心血管死亡率独立相关

王康鸣.高Glasgow预后评分与急性冠脉综合征患者的全因死亡率和心血管死亡率独立相关[J].内科急危重症杂志,2022,28(2):133-136

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DOI：10.11768/nkjwzzzz20220211

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作者	单位	E-mail
王康鸣	海口市人民医院	hkwangkangming@126.com

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中文摘要:

目的：探讨Glasgow预后评分（GPS）与急性冠脉综合征（ACS）患者不良临床预后的关系。方法：收集2016年6月至2018年6月海口市人民医院收治的ACS患者593例。本研究中，高GPS定义为GPS≥1。593例ACS患者分为2组：GPS=0组（424例，71.5%）和GPS≥1组（169例，28.5%）。不良预后为12个月的全因死亡和心血管死亡率、卒中、支架血栓形成和靶血管重建。使用逆处理概率加权（IPTW）分析来调整潜在的混杂协变量，并用Kaplan-Meier曲线表示事件发生率。结果：593例患者中位随访1.7年。GPS=0和GPS≥1的患者不良预后发生率分别为4%和8.9%。Kaplan-Meier曲线分析显示，GPS≥1组的不良预后和全因死亡率在1个月内显著高于GPS=0组（P均<0.001）。IPTW分析显示：高GPS与较高的不良预后发生率（HR:2.206；95%CI:1.085~4.486；P=0.029）、较高的全因死亡率（HR:5.963；95%CI:2.068~17.190；P<0.001）和较高的心血管死亡率（HR:6.122；95%CI:1.882~19.914；P=0.003）独立相关。结论：高GPS与ACS患者的全因死亡和心血管死亡率独立相关。GPS有助于预测ACS患者的死亡率。

英文摘要:

Objective: To investigate the relationship between Glasgow prognostic score (GPS) and poor clinical prognosis in patients with acute coronary syndrome (ACS). Methods: A total of 593 patients with ACS admitted to Haikou People's Hospital from June 2016 to June 2018 were enrolled. In this study, high GPS is defined as GPS≥1. They were divided into two groups: GPS=0 (n=424, 71.5%) and GPS≥1 (n=169, 28.5%). The main outcomes were all-cause and cardiovascular mortality, stroke, stent thrombosis, and target vessel revascularization at 12 months. Inverse processing probability weighted (IPTW) analysis was used to adjust the potential confounding covariates, and Kaplan-Meier curve was used to represent the incidence of events. Results: All 593 patients were followed up for a median of 1.7 years. The main outcome rates of GPS=0 and GPS≥1 were 4% and 8.9%, respectively. In Kaplan Meier curve analysis, the main outcome and all-cause mortality in GPS ≥1 group were significantly higher than those in GPS = 0 group within 1 month (Log-rank P<0.001, P<0.001). IPTW analysis showed that high GPS was independently associated with higher main outcome (HR: 2.206; 95% CI: 1.085-4.486; P=0.029), higher all-cause mortality (HR: 5.963; 95% CI: 2.068-17.190;P<0.001) and higher cardiovascular mortality (HR:6.122; 95%CI:1.882-19.914; P=0.003). Conclusion: High GPS is independently associated with all-cause mortality and cardiovascular mortality in ACS patients. Therefore, GPS is helpful to predict the mortality of ACS patients.