Primer perkütan koroner girişim uygulanan ST yükselmeli miyokart enfarktüslü hastalarda sol ventrikül ejeksiyon fraksiyonu ve HAS-BLED skoru kombinasyonunun mortaliteyi öngördürücü değeri

Amaç: HAS-BLED skoru ve sol ventrikül ejeksiyon fraksiyonu (SVEF), akut koroner sendromlu hastalarda her ikiside klinik sonuçları bağımsız olarak öngörebilir. Primer percutan koroner girişim (PKG) ile tedavi edilen ST segment yükselmeli miyokard infarktüsü (STEMI) hastalarında SVEF ve HAS-BLED skoru kombinasyonlarının mortaliteyi öngördürücü değerini araştırdık. Yöntemler: Primer PKG uygulanan 588 ardışık STEMI hastasını araştırdık. Her hasta için HAS-BLED skorları hesaplandı ve mortalite için öngörü değeri, eğri altındaki alan (AUC) kullanılarak analiz edildi. Hastalar HAS-BLED skorlarına göre dört gruba ayrıldı. Onların HAS-BLED skorları çok düşük risk: 0, düşük risk: 1, orta risk: 2, yüksek risk: ≥ 3 idi. Birincil son nokta toplam mortaliteydi. Bulgular: Çok değişkenli cox regresyon analizi ile HAS-BLED skoru (p <0.001) ve SVEF (p <0.001) toplam mortalitenin bağımsız öngördürücüleriydi. Sadece HAS-BLED skoru için toplam mortalitede AUC 0.71 (% 95 CI: 0.66-0.76) idi. SVEF eklendikten sonra 0.77'ye (p <0.001) yükseldi. SVEF ve HAS-BLED skorlarının birleştirilmesinin artan prediktif değeri, net yeniden sınıflandırma iyileştirmesi (NRI =% 27.2, p <0.001) ve entegre ayrımcılık iyileştirmesi (IDI = 0.061, p <0.001) ile de gösterildi. Sonuçlar: SVEF'nin HAS-BLED skoru ile birleştirilmesi, primer PKG uygulanan STEMI hastalarında tüm nedenlere bağlı mortalite için öngörüydü.

Anahtar Kelimeler:

HAS-BLED skoru, Sol ventrikül ejeksiyon fraksiyonu, Mortalite, STEMI

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