HEART 危险评分对急性冠脉综合征预后的评价作用

摘要

Objective To discuss the prognostic evaluation of HEART risk score ( RS) on the acute coronary syn-drome ( ACS) .Methods A retrospective analysis was conducted on the occurrence of the major adverse cardiovascular e -vents ( MACE) of 327 patients with ACS during hospitalization and after discharge for 1-year.The receiver operating char-acteristic curve (ROC curve) and area under the curve (AUC) of three RSs were depicted and calculated , respectively. The Hosmer-Lemeshow goodness-of-fit test was assessed on the three RSs .The incidence of MACE in the subgroups of these RSs was compared .Results ROC curve showed that HEART RS which accurately predicted in-hospital and 1-year MACE was superior to GRACE and PURSUIT RSs (P<0.05 or P<0.01).HEART RS which accurately predicted the in-hospital MACE was superior to GRACE and PURSUIT RSs (all P<0.05).Three RSs were in good goodness-of-fit.The high risk group of the HEART RS which accurately predicted the in-hospital MACE was superior to the intermediate and low risk groups (all P<0.01).Conclusion HEART is the most accurate RS to predict the short-term MACE of patients with ACS.%目的：探讨HEART危险评分（ RS）对急性冠脉综合征（ ACS）的预后评价作用。方法回顾性分析327例ACS患者随访住院期间、出院后1年主要不良心血管事件（ MACE）发生情况，分别描绘三种评分受试者特征曲线，并计算曲线下面积（ AUC）；评价三种RS的拟合优度，比较采用三种RS分组间MACE发生率的差异。结果HEART RS预测住院期间及1年MACE的准确度优于GRACE、PURSUIT RS（P＜0．05或＜0．01）；三种RS准确度的两两比较，HEART RS预测住院期间MACE的准确度优于GRACE RS、PURSUIT RS（P均＜0．05）；三种RS有较好的拟合优度。 HEART RS高危组预测住院期间MACE发生率优于低、中危组（ P均＜0．01）。结论 HEART RS预测ACS患者短期MACE的准确性较好。