Key result
A modified risk score combining the TIMI score and mean platelet volume to lymphocyte ratio strongly predicted 2-year major adverse cardiovascular events (HR 5.41) in patients with acute coronary syndrome.
Why the study?
The prognostic value of combining the TIMI risk score and mean platelet volume to lymphocyte ratio in patients with acute coronary syndrome was unknown.
Does a combined MPVLR and TIMI risk score improve the prediction of 2-year MACE and mortality in patients with acute coronary syndrome undergoing PCI compared to either score alone?
Cohort (n=472)
No
Does a combined MPVLR and TIMI risk score improve the prediction of 2-year MACE and mortality in patients with acute coronary syndrome undergoing PCI compared to either score alone?
Combining the TIMI risk score with the mean platelet volume to lymphocyte ratio (MPVLR) significantly improves the prognostic accuracy for 2-year MACE and mortality in patients with NSTEMI undergoing PCI.
Kontext: Hodnoty skĂłrovacĂho systĂŠmu Thrombolysis In Myocardial Infarction (TIMI) a pomÄru prĹŻmÄrnĂŠho objemu krevnĂch destiÄek (mean platelet volume, MPV) k poÄtu lymfocytĹŻ (lymphocyte ratio, MPVLR) pĹedstavujĂ vĂ˝znamnĂŠ parametry, jeĹž lze pouĹžĂt k predikci mortality a vzniku zĂĄvaĹžnĂ˝ch neŞådoucĂch kardiovaskulĂĄrnĂch pĹĂhod (major cardiovascular adverse events, MACE) u pacientĹŻ s akutnĂm koronĂĄrnĂm syndromem (AKS). NicmĂŠnÄ prognostickĂĄ hodnota modifikovanĂŠho skĂłrovacĂho systĂŠmu zaloĹženĂŠho na vztazĂch a kombinacĂch tÄchto parametrĹŻ u pacientĹŻ s AKS nenĂ znĂĄma. Proto jsme se rozhodli prozkoumat vztah mezi modifikovanĂ˝m rizikovĂ˝m skĂłre zĂskanĂ˝m kombinacĂ skĂłrovacĂho systĂŠmu TIMI a MPVLR v prĹŻbÄhu dvouletĂŠho sledovĂĄnĂ vĂ˝skytu MACE a mortality u pacientĹŻ s AKS. Metoda: Do naĹĄĂ studie bylo zaĹazeno 472 po sobÄ nĂĄsledujĂcĂch pacientĹŻ s diagnĂłzou AKS, lĂŠÄenĂ˝ch perkutĂĄnnĂ koronĂĄrnĂ intervencĂ. Pacienti byli hodnoceni ve dvou skupinĂĄch, jednak MACE (+) a MACE (-), za druhĂŠ jako "vysokĂĄ" a "nĂzkĂĄ" podle meznĂ hodnoty modifikovanĂŠho skĂłre MPVLR + TIMI. VĂ˝sledky: Hodnoty ploch pod kĹivkami modifikovanĂŠho skĂłre MPVLR + TIMI pro dvouletou predikci vĂ˝skytu MACE a mortality Äinily 0,893 (0,812-0,974; p < 0,001), resp. 0,864 (0,715-1,00; p = 0,001); pĹitom byly pĹesnÄjĹĄĂ neĹž hodnoty MPVLR a skĂłre TIMI samostatnÄ. AnalĂ˝za pĹeĹžitĂ pĹi pouĹžitĂ Kaplanovy-Meierovy metody prokĂĄzala, Ĺže kombinovanĂŠ skĂłre MPVLR + TIMI pĹi dlouhodobĂŠm sledovĂĄnĂ incidence MACE a mortality (log rank test: 59,329; p < 0,001, resp. log rank test: 12,085; p = 0,001) je pĹesnÄjĹĄĂ neĹž jednotlivĂŠ hodnoty skĂłre MPVLR a TIMI. V CoxovÄ regresnĂ analĂ˝ze provedenĂŠ s cĂlem urÄit faktory dlouhodobĂŠho rizika pro vznik MACE se ukĂĄzalo, Ĺže kombinovanĂŠ skĂłre MPVLR + TIMI (HR: 5,41; p = 0,006) je pĹesnÄjĹĄĂ neĹž hodnota MPVLR (HR: 2,88; p = 0,094), skĂłre TIMI (HR: 2,92; p = 0,099) a dalĹĄĂ promÄnnĂŠ. ZĂĄvÄr: Studie prokĂĄzala, Ĺže modifikovanĂŠ skĂłre MPVLR + TIMI je v predikci dvouletĂŠ mortality a incidence MACE u pacientĹŻ s AKS pĹesnÄjĹĄĂ neĹž hodnoty MPVLR a skĂłre TIMI pouĹžitĂŠ samostatnÄ.
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Yılmaz et al. (2021) conducted a cohort in Acute coronary syndrome (n=472). High MPVLR + TIMI combination score vs. Low MPVLR + TIMI combination score was evaluated on 2-year major adverse cardiovascular events (MACE) (HR 5.41, 95% CI 1.62-18.03, p=0.006). A modified risk score combining the TIMI score and mean platelet volume to lymphocyte ratio strongly predicted 2-year major adverse cardiovascular events (HR 5.41) in patients with acute coronary syndrome.
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