Comparison On The Predictive Value Of Different Scoring Systems For Death Of Long Term In Patients With ST-segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention

Objective:To compare predictive value of different scoring systems for death of long term in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention(PCI).Methods:The clinical data of 1211 patients,from January 2015 to December2015 in the cardiovascular disease diagnosis and treatment center of our hospital,who had been diagnosed as acute ST-segment elevation myocardial infarction(STEMI)and treated with PCI were analyzed and the GRACE,TIMI,CADILLAC,PAMI and NCDR scoring systems were calculated respectively.To compare the predictive value of different scoring systems for 18 months death in patients with STEMI after PCI.COX regression analysis was performed to determine the independent predictors of death in patients with acute STEMI.The predictive value of five scoring systems for predicting death after 18 months of acute STEMI after PCI was evaluated by using the receiver operating characteristic(ROC)curve.The sensitivity and specificity of the five scoring systems were analyzed by χ2test.Results:1.Compared with the survival group,the age of the death group was older(P<0.05),and the proportion of males was lower(P<0.05).There was no significant difference between the two groups in the history of old myocardial infarction,previous history of PCI,history of hypertension and history of diabetes(P>0.05).There were significant differences in systolic blood pressure,Killip classification,ejection fraction and glomerular filtration rate between the two groups(P<0.05).In terms of vascular lesions,the proportion of final blood flow in the death group was higher than that in the survival group,but there was no significant difference(P=0.075),and there was no significant difference in the proportion of three-vessel lesions(P=0.238).2.When applying age,sex,systolic blood pressure,Killip classification,ejection fraction,glomerular filtration rate,TIMI grade of final blood flow and three-vessel lesions into multivariate COX regression analysis,we found age,Killip grade and systolic blood pressure(SBP)remained as independent predictors of all-cause death.3.The scores of GRACE,TIMI,CADILLAC,PAMI and NCDR in the death group were higher than those in the survival group,and there was significant difference(P<0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)for predicting 18 months death of GRACE,TIMI,CADILLAC,PAMI and NCDR scoring systems were0.838,0.801,0.781,0.750 and 0.775 respectively.All the five scoring systems had better predictive value,but there was no significant difference in sensitivity and specificity among the five systems(P > 0.05).Conclusion:1.Age,Killip grade,and systolic blood pressure(SBP)remained as independent predictors of long-term death.2.The five scoring systems are all suitable for predicting the long-term death in patients with acute myocardial infarction after PCI.The predictive value of which scoring system is better remains to be determined.