Association of MELD-XI score with adverse events in patients with ST-segment elevation myocardial infarction

【摘要】 Background It is unclear whether the model for end-stage liver disease excluding international normalized ratio(MELD-XI), in addition to the Thrombolysis In Myocardial Infarction(TIMI) risk score, had prognostic value in patients with ST-segment elevation myocardial infarction(STEMI) undergoing percutaneous coronary intervention(PCI). Methods 189 STEMI patients undergoing PCI were consecutively included and classified into two groups based on the cut-off of MELD-XI, which was determined by receiver operating characteristic(ROC)curve analysis: low MELD-XI group(<10, n=135) and high MELD-XI group(≥10, n=54). The association of MELD-XI with adverse events was analyzed. Results During hospitalization, 5(2.6%) patients died, 57(30.2%) suffered acute heart failure, 4(2.1%) needed renal replacement treatment, 2(1.1%) suffered stroke and 1(0.5%) received target vessel revascularization. ROC curve analysis showed that MELD-XI ≥10 was an optimal cut-off for predicting in-hospital MACEs [area under the curve(AUC): 0.684, 95% CI: 0.599-769, P<0.001]. The in-hospital major adverse clinical events(MACEs) was significantly higher in patients with high MELD-XI(51.9% vs. 23.0%, P<0.001). Multivariate analysis showed that MELD-XI ≥10 was an independent risk factor for in-hospital MACEs after adjusting for TIMI risk score(OR: 3.59, 95% CI: 1.79-7.19, P<0.001). Conclusions MELD-XI, in addition to the TIMI risk score, might provide prognostic value for STEMI patients undergoing PCI.[S Chin J Cardiol 2021;22(2):75-79]更多还原

【Abstract】 Background It is unclear whether the model for end-stage liver disease excluding international normalized ratio(MELD-XI), in addition to the Thrombolysis In Myocardial Infarction(TIMI) risk score, had prognostic value in patients with ST-segment elevation myocardial infarction(STEMI) undergoing percutaneous coronary intervention(PCI). Methods 189 STEMI patients undergoing PCI were consecutively included and classified into two groups based on the cut-off of MELD-XI, which was determined by receiver operating characteristic(ROC)curve analysis: low MELD-XI group(<10, n=135) and high MELD-XI group(≥10, n=54). The association of MELD-XI with adverse events was analyzed. Results During hospitalization, 5(2.6%) patients died, 57(30.2%) suffered acute heart failure, 4(2.1%) needed renal replacement treatment, 2(1.1%) suffered stroke and 1(0.5%) received target vessel revascularization. ROC curve analysis showed that MELD-XI ≥10 was an optimal cut-off for predicting in-hospital MACEs [area under the curve(AUC): 0.684, 95% CI: 0.599-769, P<0.001]. The in-hospital major adverse clinical events(MACEs) was significantly higher in patients with high MELD-XI(51.9% vs. 23.0%, P<0.001). Multivariate analysis showed that MELD-XI ≥10 was an independent risk factor for in-hospital MACEs after adjusting for TIMI risk score(OR: 3.59, 95% CI: 1.79-7.19, P<0.001). Conclusions MELD-XI, in addition to the TIMI risk score, might provide prognostic value for STEMI patients undergoing PCI.[S Chin J Cardiol 2021;22(2):75-79]更多还原