Predictive Value of Modified Level of Plasma Lactic Acid and Shock Index to Short-term Prognosis in Patients with ST-segment Elevation Myocardial Infarction
WANG Yanfei, ZHAO Chunsheng, NIU Xingjie, et al
The Affiliated Hospital of Chengde Medical College, Hebei Chengde 067000, China
Abstract：Objective: To study the predictive value of level of plasma lactic acid (LA) and modified shock index (MSI) for 10-day outcome to short-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods:STEMI patients (n=678) were chosen from the Department of Emergency in the Affiliated Hospital of Chengde Medical College from June 2015 to June 2017. According to the level of LA level and MSI, the patients were divided into higher group (LA≥2 mmoL/L) and normal group and (LA<2 mmoL/L ), and MSI≥1.3 group and MSI<1.3 group. The general data of the patients was recorded, and major cardiac adverse events (MACE) in 10 days was reviewed and the incidence of all-cause mortality was observed, and predictive value of two indexes to short-term prognosis was analyzed by using area under curve (AUC) of receiver operating characteristic curve (ROC). Results: The difference in systolic blood pressure, diastolic blood pressure, heart rate, grades Ⅲ and Ⅳ of Killip grading had statistical significance between LA higher and normal group (P<0.05). The incidence of fatal arrhythmias and cardiogenic shock and all-cause mortality were significantly LA higher group than those in LA normal group (P<0.05). The difference in systolic blood pressure, diastolic blood pressure, heart rate, grades Ⅲ and Ⅳ of Killip grading had statistical significance between MSI≥1.3 group and MSI<1.3 group. The incidence of fatal arrhythmias and cardiogenic shock and all-cause mortality were significantly higher in MSI≥1.3 group than those in MSI<1.3 group (P<0.05). The hospital mortality was 7.52%. AUC of LA was 0.823 and AUC of MSI was 0.789 ,which had statistical significance in prediction of short-term prognosis in STEM patients. Conclusion: LA and MSI all have some predictive value to short-term prognosis in STEM patients, and LA has higher predictive value.
王艳飞, 赵春生, 牛兴杰, 张爱文, 于健. 乳酸检测和纠正休克指数在急诊对STEMI患者短期预后的预测价值[J]. 河北医学, 2018, 24(6): 947-950.
WANG Yanfei, ZHAO Chunsheng, NIU Xingjie, et al. Predictive Value of Modified Level of Plasma Lactic Acid and Shock Index to Short-term Prognosis in Patients with ST-segment Elevation Myocardial Infarction. HeBei Med, 2018, 24(6): 947-950.
[1] Fang J,Alderman MH,Keenan NL,et al.Acute myocardial infarction hospitalization in the United States 1979 to 2005[J].Am Med,2010,123:259~266. [2] Kilic T,Ermis H,Gulbas G,et al.Prognostic role of the simplified pulmonary embolism severity index and shock index in pulmonary embolism[J].Pol Arch Med Wewn,2014,124(12):678~687. [3] Qing S, Xu J, Su H, et al.Modified Shock Index is a predictor for 7-day outcomes in patients with STEMI[J].Am EmergMed,2015,33(8):1072~1075. [4] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):380~392. [5] Dascenzo F,Biondi-zoccai G,Moretri C,et al.GRACE and alternative risk scores in acute coronary syndromes:a meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients[J].Contemp Clin Trials,2012(33):507~514. [6]Hirohide Matsuura NK,Tatsuya Nakama MF,Hiroshi Koiwaya AM,et al .Blood lactate level at coronary care unit can predict short-term prognosis after primary percutaneous coronary intervention for acute myocardial infarction[J].JACC,2016,67(13):488. [7] Huang B, Yang Y, Zhu J, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction [J].Am Cardiol,2014,114(9):1315~1321. [8] Singh A,Ali S,Agarwal A,et al.Corelation of Shock Index and Modified Shock Index with the outcome of adult trauma patients:a prospective study of 9860 patients[J].N Am Med Sci,2014,6(9):450~452.
2018, Vol. 24 
冀公网安备13080202000677号