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@article{1369797,
author = {Tesák, Martin and Kala, Petr and Jarkovský, Jiří and Poloczek, Martin and Boček, Otakar and Jerabek, Petr and Kubková, Lenka and Manousek, Jan and Špinar, Jindřich and Mebazaa, Alexandre and Pařenica, Jiří and CohenandSolal, Alain},
article_location = {Clare (Ireland)},
article_number = {JUL 1 2016},
doi = {http://dx.doi.org/10.1016/j.ijcard.2016.03.073},
keywords = {Acute myocardial infarction; Heart failure; Hemodynamics; Prognosis; Natriuretic peptide},
language = {eng},
issn = {0167-5273},
journal = {International Journal of Cardiology},
title = {The value of novel invasive hemodynamic parameters added to the TIMI risk score for short-term prognosis assessment in patients with ST segment elevation myocardial infarction},
volume = {214},
year = {2016}
}
TY - JOUR
ID - 1369797
AU - Tesák, Martin - Kala, Petr - Jarkovský, Jiří - Poloczek, Martin - Boček, Otakar - Jerabek, Petr - Kubková, Lenka - Manousek, Jan - Špinar, Jindřich - Mebazaa, Alexandre - Pařenica, Jiří - Cohen-Solal, Alain
PY - 2016
TI - The value of novel invasive hemodynamic parameters added to the TIMI risk score for short-term prognosis assessment in patients with ST segment elevation myocardial infarction
JF - International Journal of Cardiology
VL - 214
IS - JUL 1 2016
SP - 236-241
EP - 236-241
PB - Elsevier Ireland Ltd.
SN - 01675273
KW - Acute myocardial infarction
KW - Heart failure
KW - Hemodynamics
KW - Prognosis
KW - Natriuretic peptide
N2 - Background: We compared the prognostic capacity of conventional and novel invasive parameters derived from the slope of the preload recruitable stroke work relationship (PRSW) in STEMI patients and assessed their contribution to the TIMI risk score. Methods: Left ventricular end-diastolic pressure (EDP), ejection fraction (EF), pressure adjusted maximum rate of pressure change in the left ventricle (dP/dt/P), aortic systolic pressure to EDP ratio (SBP/EDP) and end-diastolic volume adjusted stroke work (EW), derived from the slope of the PRSW relationship, were obtained during the emergency cardiac catheterization in 523 STEMI patients. The predictive power of the analyzed parameters for 30-day and 1-year mortality was evaluated using C-statistics and reclassification analysis was adopted to assess the improvement in TIMI score. Results: The highest area under the curve (AUC) values for 30-day mortality were observed for EW (0.872(95% confidence interval 0.801-0.943)), SBP/EDP (0.843(0.758-0.928)) and EF (0.833(0.735-0.931)); p < 0.001 for all values. For 1-year mortality the best predictive value was found for EW (0.806(0.724-0.887) and EF (0.793(0.703-0.883)); p < 0.001 for both. The addition of EDP, SBP/EDP ratio and EW to TIMI score significantly increased the AUC according to De Long's test. For 30-day mortality, increased discriminative power following addition to the TIMI score was observed for EW and SBP/EDP (Integrated Discrimination Improvement was 0.086(0.033-0.140), p = 0.002 and 0.078(0.028-0.128), p = 0.002, respectively). Conclusions: EW and SBP/EDP are prognostic markers with high predictive value for 30-day and 1-year mortality. Both parameters, easily obtained during emergency catheterization, improve the discriminatory capacity of the TIMI score for 30-day mortality. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
ER -
TESÁK, Martin, Petr KALA, Jiří JARKOVSKÝ, Martin POLOCZEK, Otakar BOČEK, Petr JERABEK, Lenka KUBKOVÁ, Jan MANOUSEK, Jindřich ŠPINAR, Alexandre MEBAZAA, Jiří PAŘENICA and Alain COHEN-SOLAL. The value of novel invasive hemodynamic parameters added to the TIMI risk score for short-term prognosis assessment in patients with ST segment elevation myocardial infarction. \textit{International Journal of Cardiology}. Clare (Ireland): Elsevier Ireland Ltd., 2016, vol.~214, JUL 1 2016, p.~236-241. ISSN~0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2016.03.073.
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