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【medical-news】连续ST段监测在急性冠脉综合征中的
NEW YORK (Reuters Health) May 10 - Continuous ST-segment monitoring during the first 48 hours in patients with non-ST-elevation acute coronary syndrome (ACS) provides long-term prognostic information independent of comprehensive risk assessment on presentation. This may help identify high-risk patients who benefit from early revascularization, researcher say.
"In patients with acute coronary syndromes, recurrent ischemia detected by continuous electrocardiographic monitoring portends a poor outcome," Dr. Shaun G. Goodman, of the University of Toronto, Ontario, Canada, and colleagues write in the April issue of the American Heart Journal.
In their study, the researchers examined the additional long-term prognostic value of continuous ST-segment monitoring beyond the Global Registry of Acute Coronary Events (GRACE) risk score, a validated predictor of in-hospital mortality, in ACS.
The researchers determined the GRACE risk score in 681 non-ST-elevation ACS patients enrolled in a treatment trial. Components of the GRACE risk score include age, admission heart rate, systolic blood pressure, Killip class, cardiac arrest, ST-segment deviation on ECG, serum creatinine, and cardiac biomarker status.
An automated algorithm was used to analyze continuous ST-segment monitoring in the first 48 hours.
The subjects had a median GRACE risk score of 115. ST-segment shifts were present in 19.1% of the patients during the first 48 hours. GRACE risk scores were 129 in patients with ST-segment shifts, compared with 113 in patients without ST-segment shifts (p < 0.001).
Patients were followed for a median of 30 months. The cumulative mortality rate during follow-up was 8.1%, and the incidence of the composite end point of death or nonfatal (re-)MI was 13.7%.
Overall, 17.7% of patients with ST-segment shifts died during follow-up, compared with 5.8% of those without (p < 0.001). Patients with ST-segment shifts were also more likely to reach the composite end point (24.6% versus 11.1%, p < 0.001).
Multivariable analysis adjusting for GRACE risk score demonstrated that the presence of ST-segment shifts remained an independent predictor of death (adjusted hazard ratio [HR] = 2.37, p = 0.002) and death/MI (adjusted HR = 1.93, p = 0.003).
Early continuous monitoring provides useful long-term prognostic information, Dr. Goodman and colleagues conclude, saying, "More widespread utilization of this valuable noninvasive risk stratification tool should be considered in the routine management of ACS."
Am Heart J 2007;153:500-506.
http://www.medscape.com/viewarticle/556331 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Prognostic Value Seen in Continuous ST-Segment Monitoring in ACS
连续ST段监测在急性冠脉综合征中的预测价值
NEW YORK (Reuters Health) May 10 - Continuous ST-segment monitoring during the first 48 hours in patients with non-ST-elevation acute coronary syndrome (ACS) provides long-term prognostic information independent of comprehensive risk assessment on presentation. This may help identify high-risk patients who benefit from early revascularization, researcher say.
据纽约路透社健康5月10日讯，在发生无ST段抬高的急性冠脉综合征病人发病后的第一个48小时内，连续的ST段监测提供了长期的预后信息，而且这些信息不依赖于对病人表现的综合危险率的评估。
"In patients with acute coronary syndromes, recurrent ischemia detected by continuous electrocardiographic monitoring portends a poor outcome," Dr. Shaun G. Goodman, of the University of Toronto, Ontario, Canada, and colleagues write in the April issue of the American Heart Journal.
“在急性冠脉综合征病人中，连续心电图监测出现再发局部缺血预后不良，”加拿大安大略省多伦多大学Goodman医生和他的同事在4月出版的美国心脏杂志上写到。
In their study, the researchers examined the additional long-term prognostic value of continuous ST-segment monitoring beyond the Global Registry of Acute Coronary Events (GRACE) [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-06-06 21:37
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