医学
传统PCI
经皮冠状动脉介入治疗
危险系数
内科学
临床终点
心肌梗塞
心脏病学
人口
置信区间
外科
临床试验
环境卫生
作者
Chunfeng Dai,Zheng Yang,Muyin Liu,You Zhou,Danbo Lu,Shufu Chang,Chenguang Li,Hao Lu,Zhangwei Chen,Juying Qian,Junbo Ge
标识
DOI:10.1016/j.ijcard.2023.131258
摘要
Background In our previous study, the PIANO score was constructed to predict the occurrence of no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PCI). In the current analysis, we sought to evaluate the prognostic value and clinical usefulness of the PIANO score in this population. Methods Patients with acute myocardial infarction (AMI) undergoing primary PCI were consecutively enrolled and followed up in this register. The endpoint of interest was all-cause mortality at 2 years after the procedure. The clinical benefits of thrombus aspiration (TA) during primary PCI in certain subgroups were also evaluated as exploratory analyses. Results A total of 2100 patients were identified, and 54.3% had high (≥8) PIANO score. After 2-year follow-up, patients with high PIANO score had higher risk of all-cause mortality after adjustment for propensity score (6.7% vs. 3.1%, adjusted hazard ratio = 2.11 [1.21–3.68], p = 0.008), especially in the first month (adjusted hazard ratio = 2.33 [1.17–4.65], p = 0.017). Restricted cubic spline analysis indicated the linear association between the PIANO score and 2-year all-cause mortality (nonlinear p = 0.556). Further analysis demonstrated that TA did not reduce all-cause mortality in the overall patients, as well as in those with visible thrombus, high thrombus burden, or occlusive lesions. However, the PIANO score defined "high-risk" (PIANO score ≥ 8) patients could benefit from it. Conclusions The PIANO score had potential prognostic value in patients with AMI undergoing primary PCI. It might also be helpful for identifying patients who would benefit from TA. These observations require further confirmation in future studies.
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