To Explore The Correlation Between ViEWS And Hospital Prognosis In Patients With STEMI

Objective:In this study,we calculated the vitaly PAC early warning score(ViEWS)of patients with STEMI,recorded whether major adverse cardiovascular events(MACE)occurred during hospitalization,and explored whether there was a correlation between ViEWS and hospital prognosis of patients with STEMI.Method:A total of 213 patients with acute ST segment elevation myocardial infarction who met the diagnostic criteria were collected from the emergency department and cardiology department of the affiliated cardio cerebrovascular Hospital of Yan'an University from October 2018 to October 2019.The basic clinical data of each patient were collected by taking whether MACE occurred during the hospitalization as the observation index and discharge as the observation end point.The patients were divided into low ViEWS group and high ViEWS group according to the best critical value.The clinical basic data and prognosis of the two groups were compared.According to whether MACE occurred during hospitalization,patients were divided into MACE group and non MACE group.The clinical basic data and ViEWS of the two groups were compared.Single factor significant binary logistic regression analysis was used to find out independent predictors of MACE in STEMI patients.Result:1.ROC curve analysis showed that: the AUC of ViEWS was 0.75,AUC of TIMI was 0.788,and the area under the two scoring curves was greater than 0.7,which indicated that the two scores had predictive effect on the occurrence of mace events in the hospital of patients with acute STEMI,and the predictive effect was similar.The best diagnostic threshold of views score for predicting the risk of mace events in STEMI patients was 5(sensitivity 63.6%,specificity 80.6%,Jordan index 0.442,p < 0.01).2.According to the critical value group,there were 162 cases(76.06%)in the low ViEWS group and 51 cases(23.94%)in the high ViEWS group.The comparison of theclinical basic data between the two groups showed that there were statistically significant differences in heart rate,diastolic pressure,systolic pressure killip??and LVEF(P <0.05).The results showed that the incidence of mace in high ViEWS group was significantly higher than that in low ViEWS group(P < 0.05).3.According to the prognosis of patients: 22 cases(10.33%)in MACE group and191 cases(89.67%)in non MACE group,the clinical basic data of the two groups were analyzed.The results showed that: LDL,age,serum triglyceride,total cholesterol,troponin I,CK-MB,NT proBNP,ViEWS score,systolic blood pressure,history of hypertension,killip grade ? grade II,LVEF were statistically significant(P < 0.05).4.Multivariate logistic regression analysis showed that: history of hypertension(OR=3.535,95%CI:1.049-11.913,p<0.05),serum triglyceride(OR=1.772,95%CI:1.023-3.071,p<0.05),troponin I(OR=1.030,95%CI:1.006-1.054,p<0.05),killip? grade II(OR=4.696,95%CI:1.258-17.525,p<0.05),ViEWS(OR=1.852,95%CI:1.025-3.348,p<0.05),were independent predictors of the risk of mace events in patients with STEMI.Conclusion:1.ViEWS has predictive value for MACE in STEMI patients,and the predictive effect is similar to TIMI score.2.ViEWS is an independent predictor of MACE in patients with STEMI.The higher the ViEWS,the higher the risk of MACE event in hospital.