Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly p...Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly patients-who are often underrepresented in validation studies and present with unique pathophysiology-is not well established.This study was designed to directly evaluate and compare the predictive value of the ACEF score for short-term mortality in elderly versus non-elderly STEMI patients,addressing a critical gap in its clinical application.Methods We enrolled 934 consecutive STEMI patients undergoing percutaneous coronary intervention,categorized into a non elderly group(<65 years,n=534)and an elderly group(≥65 years,n=400).The ACEF score was calculated as age/left ventricular ejection fraction+1(if serum creatinine>2 mg/dL).Its predictive ability for in hospital and one year mortality was assessed.Results Overall,in hospital and one year mortality rates were 4.4%and 8.2%,respectively.Elderly patients had significantly worse in hospital outcomes,including higher all cause mortality(6.5%vs.2.8%,P=0.006)and major adverse cardiovascular events(16.0%vs.9.2%,P=0.002).The predictive performance of the ACEF score for in hospital mortality was lower in the elderly group than in the non elderly group(area under the curve:0.753 vs.0.828,P=0.047).The optimal cut off value for ACEF was 1.65 in both groups.In multivariate analysis,an ACEF score>1.65 independently predicted in hospital mortality[adjusted odds ratio(OR):11.58,P=0.001]and one year mortality[adjusted hazard ratio(HR):7.12,P<0.001]in non elderly patients.Similar associations were observed in elderly patients(in hospital mortality:adjusted OR:3.26,P=0.027;one year mortality:adjusted HR:2.79,P=0.003).Conclusions Despite a relatively lower discriminatory ability for short-term mortality in elderly STEMI patients,the ACEF score still demonstrated significant predictive value and might serve as a practical,initial tool for identifying high-risk individuals in clinical settings.展开更多
目的:探讨年龄、肌酐和射血分数(ACEF)评分对冠心病患者冠状动脉病变严重程度和院内不良心血管事件的预测价值。方法:回顾性分析武汉大学中南医院2019年1—12月首次行冠状动脉造影确诊为冠心病的患者748例,按照ACEF评分分为低分组(≤1.0...目的:探讨年龄、肌酐和射血分数(ACEF)评分对冠心病患者冠状动脉病变严重程度和院内不良心血管事件的预测价值。方法:回顾性分析武汉大学中南医院2019年1—12月首次行冠状动脉造影确诊为冠心病的患者748例,按照ACEF评分分为低分组(≤1.00)364例和高分组(>1.00)384例,比较两组患者的临床基线资料、冠脉造影结果、院内不良心血管事件发生率。使用相关性分析及回归分析分析冠脉狭窄程度的危险因素。采用受试者工作特征(ROC)曲线分析ACEF评分预测高冠脉积分及院内不良心血管事件的效能。结果:ACEF高分组Gensini评分较ACEF低分组高(58.0 vs 43.8,P<0.01)。Spearman相关分析提示ACEF评分与Gensini评分呈正相关(ρ=0.253,P<0.01)。多元线性回归分析及Logistic回归分析显示高ACEF评分是高Gensini评分的独立危险因素。ACEF评分预测高冠脉积分ROC曲线下面积为0.717(95%CI:0.633~0.801,P<0.01)。当ACEF为1.056,其诊断效率最高,敏感度为75.6%,特异度为58.6%。结论:高ACEF评分的冠心病患者多合并更多的心血管危险因素及更严重的冠脉病变。ACEF评分对冠心病患者的院内不良心血管事件具有一定预测效能。展开更多
Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ej...Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ejection fraction(ACEF)score with in-hospital prognosis of patients with the acute type A aortic dissection(ATAAD).Methods From September 2017 to June 2021,a total of 435 ATAAD patients undergoing open surgery repair were enrolled,and classified into low ACEF(ACEF score<0.91,n=286)and high ACEF group(ACEF score≥0.91,n=149)according to the optimal cutoff value of 0.91.Logistic regression analysis was performed to investigate the association between ACEF score with adverse events.Results Thirty-five(8.0%)patients were excluded and 94(21.6%)developed in-hospital major adverse clinical events(MACEs)during hospitalization.The in-hospital mortality in high ACEF group was significantly higher than in low ACEF group(13.4%vs.5.2%,P=0.003).The in-hospital MACE rate was also significantly higher in patients with high ACEF score(high ACEF group:27.5%vs.low ACEF group:18.5%,P=0.031).Multivariable logistic analysis revealed that ACEF score was an independent indicator for in-hospital mortality[odds ratio(OR):5.66,95%confidence interval(CI):1.43-22.48,P=0.014]and in-hospital MACEs(OR:3.44,95%CI:1.30-9.15,P=0.013).Conclusions Elevated ACEF score was an independent predictor for in-hospital mortality and MACEs in patients with ATAAD undergoing open surgery repair,which might provide additional risk stratification.展开更多
Background:The purpose of this study was to explore whether consideration of FIB levels might improve the predic-tive value of the ACEF score in patients with ACS.Methods:A total of 290 patients with ACS were enrolled...Background:The purpose of this study was to explore whether consideration of FIB levels might improve the predic-tive value of the ACEF score in patients with ACS.Methods:A total of 290 patients with ACS were enrolled in this study.The clinical characteristics and MACE were recorded.Results:Multivariate logistic regression analysis revealed that the FIB level(odds ratio=7.798,95%CI,3.44–17.676,P<0.001)and SYNTAX score(odds ratio=1.034,95%CI,1.001–1.069,P=0.041)were independent predictors of MACE.On the basis of the regression coefficient for FIB,the ACEF-FIB was developed.The area under the ROC of the ACEF-FIB scoring system in predicting MACE after PCI was 0.753(95%CI 0.688–0.817,P<0.001),a value greater than those for the ACEF score,SYNTAX score and Grace score(0.627,0.637 and 0.570,respectively).Conclusion:ACEF-FIB had better discrimination ability than the other risk scores,according to ROC curve analysis,net reclassification improvement and integrated discrimination improvement.展开更多
Background The age, creatinine levels, and the ejection fraction Ⅱ score(ACEF Ⅱ score) are significant indicators for assessing inflammation and predicting adverse outcomes following cardiac surgery. Our objective w...Background The age, creatinine levels, and the ejection fraction Ⅱ score(ACEF Ⅱ score) are significant indicators for assessing inflammation and predicting adverse outcomes following cardiac surgery. Our objective was to investigate the predictive value of the recently updated ACEF Ⅱ score concerning perioprative blood transfusion in adult patients undergoing cardiac surgery. Methods A retrospective review was conducted involving adults(≥18 years) who underwent cardiac surgery for heart disease between January 2019 and June 2019. The primary outcome measure was perioperative blood transfusion among adult patients. Multivariable logistic regression and receiver operation characteristic(ROC) analysis were applied to analyze the link between the ACEF Ⅱ score and perioperative blood transfusion. Results A total of 415 patients were included, participants were stratified into three groups based on their ACEF Ⅱ scores level: ACEF Ⅱ <0.666, 0.666 ≤ ACEF Ⅱ <0.950, and 0.950 ≤ ACEF II ≤4.781. Multivariable Logistic regression analysis indicated that a high ACEF Ⅱ score(OR: 3.59, 95% CI: 1.68-7.67, P<0.001) was independently associated with an increased risk of perioperative blood transfusion among adults undergoing cardiac surgery. Furthermore, the area under the receiver operating characteristic curve for predicting perioperative blood transfusion risk using the ACEF Ⅱ score was found to be 0.607. The Pearson correlation coefficient showed a direct and statistically significant positive correlation between ACEF Ⅱ score and perioperative blood transfusion(r=0.17, P<0.001). Conclusions In conclusion, our findings suggested that the ACEF Ⅱ score possessed significant predictive value regarding related to perioperative blood transfusions during cardiac surgical procedures in adult patients. The higher the ACEF Ⅱ score, the higher incidence of perioperative blood transfusions.展开更多
文摘Background Although the age,creatinine,and ejection fraction(ACEF)score effectively predicts risk in general populations with ST segment elevation myocardial infarction(STEMI),its performance specifically in elderly patients-who are often underrepresented in validation studies and present with unique pathophysiology-is not well established.This study was designed to directly evaluate and compare the predictive value of the ACEF score for short-term mortality in elderly versus non-elderly STEMI patients,addressing a critical gap in its clinical application.Methods We enrolled 934 consecutive STEMI patients undergoing percutaneous coronary intervention,categorized into a non elderly group(<65 years,n=534)and an elderly group(≥65 years,n=400).The ACEF score was calculated as age/left ventricular ejection fraction+1(if serum creatinine>2 mg/dL).Its predictive ability for in hospital and one year mortality was assessed.Results Overall,in hospital and one year mortality rates were 4.4%and 8.2%,respectively.Elderly patients had significantly worse in hospital outcomes,including higher all cause mortality(6.5%vs.2.8%,P=0.006)and major adverse cardiovascular events(16.0%vs.9.2%,P=0.002).The predictive performance of the ACEF score for in hospital mortality was lower in the elderly group than in the non elderly group(area under the curve:0.753 vs.0.828,P=0.047).The optimal cut off value for ACEF was 1.65 in both groups.In multivariate analysis,an ACEF score>1.65 independently predicted in hospital mortality[adjusted odds ratio(OR):11.58,P=0.001]and one year mortality[adjusted hazard ratio(HR):7.12,P<0.001]in non elderly patients.Similar associations were observed in elderly patients(in hospital mortality:adjusted OR:3.26,P=0.027;one year mortality:adjusted HR:2.79,P=0.003).Conclusions Despite a relatively lower discriminatory ability for short-term mortality in elderly STEMI patients,the ACEF score still demonstrated significant predictive value and might serve as a practical,initial tool for identifying high-risk individuals in clinical settings.
文摘目的:探讨年龄、肌酐和射血分数(ACEF)评分对冠心病患者冠状动脉病变严重程度和院内不良心血管事件的预测价值。方法:回顾性分析武汉大学中南医院2019年1—12月首次行冠状动脉造影确诊为冠心病的患者748例,按照ACEF评分分为低分组(≤1.00)364例和高分组(>1.00)384例,比较两组患者的临床基线资料、冠脉造影结果、院内不良心血管事件发生率。使用相关性分析及回归分析分析冠脉狭窄程度的危险因素。采用受试者工作特征(ROC)曲线分析ACEF评分预测高冠脉积分及院内不良心血管事件的效能。结果:ACEF高分组Gensini评分较ACEF低分组高(58.0 vs 43.8,P<0.01)。Spearman相关分析提示ACEF评分与Gensini评分呈正相关(ρ=0.253,P<0.01)。多元线性回归分析及Logistic回归分析显示高ACEF评分是高Gensini评分的独立危险因素。ACEF评分预测高冠脉积分ROC曲线下面积为0.717(95%CI:0.633~0.801,P<0.01)。当ACEF为1.056,其诊断效率最高,敏感度为75.6%,特异度为58.6%。结论:高ACEF评分的冠心病患者多合并更多的心血管危险因素及更严重的冠脉病变。ACEF评分对冠心病患者的院内不良心血管事件具有一定预测效能。
基金supported by the Science and Technology Planning Project of Guangzhou(No.2014y2-00052)。
文摘Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ejection fraction(ACEF)score with in-hospital prognosis of patients with the acute type A aortic dissection(ATAAD).Methods From September 2017 to June 2021,a total of 435 ATAAD patients undergoing open surgery repair were enrolled,and classified into low ACEF(ACEF score<0.91,n=286)and high ACEF group(ACEF score≥0.91,n=149)according to the optimal cutoff value of 0.91.Logistic regression analysis was performed to investigate the association between ACEF score with adverse events.Results Thirty-five(8.0%)patients were excluded and 94(21.6%)developed in-hospital major adverse clinical events(MACEs)during hospitalization.The in-hospital mortality in high ACEF group was significantly higher than in low ACEF group(13.4%vs.5.2%,P=0.003).The in-hospital MACE rate was also significantly higher in patients with high ACEF score(high ACEF group:27.5%vs.low ACEF group:18.5%,P=0.031).Multivariable logistic analysis revealed that ACEF score was an independent indicator for in-hospital mortality[odds ratio(OR):5.66,95%confidence interval(CI):1.43-22.48,P=0.014]and in-hospital MACEs(OR:3.44,95%CI:1.30-9.15,P=0.013).Conclusions Elevated ACEF score was an independent predictor for in-hospital mortality and MACEs in patients with ATAAD undergoing open surgery repair,which might provide additional risk stratification.
文摘Background:The purpose of this study was to explore whether consideration of FIB levels might improve the predic-tive value of the ACEF score in patients with ACS.Methods:A total of 290 patients with ACS were enrolled in this study.The clinical characteristics and MACE were recorded.Results:Multivariate logistic regression analysis revealed that the FIB level(odds ratio=7.798,95%CI,3.44–17.676,P<0.001)and SYNTAX score(odds ratio=1.034,95%CI,1.001–1.069,P=0.041)were independent predictors of MACE.On the basis of the regression coefficient for FIB,the ACEF-FIB was developed.The area under the ROC of the ACEF-FIB scoring system in predicting MACE after PCI was 0.753(95%CI 0.688–0.817,P<0.001),a value greater than those for the ACEF score,SYNTAX score and Grace score(0.627,0.637 and 0.570,respectively).Conclusion:ACEF-FIB had better discrimination ability than the other risk scores,according to ROC curve analysis,net reclassification improvement and integrated discrimination improvement.
文摘Background The age, creatinine levels, and the ejection fraction Ⅱ score(ACEF Ⅱ score) are significant indicators for assessing inflammation and predicting adverse outcomes following cardiac surgery. Our objective was to investigate the predictive value of the recently updated ACEF Ⅱ score concerning perioprative blood transfusion in adult patients undergoing cardiac surgery. Methods A retrospective review was conducted involving adults(≥18 years) who underwent cardiac surgery for heart disease between January 2019 and June 2019. The primary outcome measure was perioperative blood transfusion among adult patients. Multivariable logistic regression and receiver operation characteristic(ROC) analysis were applied to analyze the link between the ACEF Ⅱ score and perioperative blood transfusion. Results A total of 415 patients were included, participants were stratified into three groups based on their ACEF Ⅱ scores level: ACEF Ⅱ <0.666, 0.666 ≤ ACEF Ⅱ <0.950, and 0.950 ≤ ACEF II ≤4.781. Multivariable Logistic regression analysis indicated that a high ACEF Ⅱ score(OR: 3.59, 95% CI: 1.68-7.67, P<0.001) was independently associated with an increased risk of perioperative blood transfusion among adults undergoing cardiac surgery. Furthermore, the area under the receiver operating characteristic curve for predicting perioperative blood transfusion risk using the ACEF Ⅱ score was found to be 0.607. The Pearson correlation coefficient showed a direct and statistically significant positive correlation between ACEF Ⅱ score and perioperative blood transfusion(r=0.17, P<0.001). Conclusions In conclusion, our findings suggested that the ACEF Ⅱ score possessed significant predictive value regarding related to perioperative blood transfusions during cardiac surgical procedures in adult patients. The higher the ACEF Ⅱ score, the higher incidence of perioperative blood transfusions.
