Prins, J. (Jake) (2017) The prognostic value of arterial blood gas parameters in ST-elevation myocardial infarctionpatients who underwent percutaneous coronary intervention. thesis, Medicine.
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Abstract
The prognostic value of arterial blood gas (ABG) parameters in patients presenting with an ST-elevation myocardial infarction (STEMI) who were treated with percutaneous coronary intervention (PCI) has not been established. Therefore, the primary aim of this study was to determine if ABG parameters are predictors of long-term clinical outcome in this population. A secondary aim was to develop a practical risk score based on the prediction model. This is a retrospective study of 678 STEMI patients who received PCI at the University Medical Center Groningen (UMCG) between 2008 and 2010. The cohort was split into a derivation set (452 patients) to derive the prediction model and a validation set (226 patients) to validate the risk score. Data was obtained from the hospital STEMI registry. The primary endpoint was all-cause 1-year mortality. For the risk score, each independent predictor was assigned weighted points proportional to their ß-coefficient. Patients were divided into low-and high-risk groups based on their individual risk scores. The main ABG parameters were not associated with 1-year all-cause mortality. After multivariate regression analysis, hemoglobin was the only ABG parameter which demonstrated significant prognostic value. The final prediction model consisted of age, heart rate, hemoglobin, cardiogenic shock (CS) and peak troponin T. After dichotomizing the predictors, only age, anemia and CS remained significant and were used for the risk score. The c-statistic of the risk score for 1-year all-cause mortality was 0.85 in the derivation set and 0.89 in the validation set. The 1-year mortality rates in the low risk groups were 2.7% and 1.5% and in the high risk groups 31% and 40% in the derivation and validation sets, respectively. The findings suggest that the main ABG parameters offer limited prognostic value in STEMI patients who received PCI. The developed practical risk score accurately predicts long-term clinical outcome.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Harst, Prof. dr. P. van der and Department of Cardiology, University medical center Groninge |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1108 |
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