Objective:To compare the predictive values of the Global Registry of Acute Coronary Events (GRACE) risk scores, the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial scores, and the Thrombolysis In Myocardial Infarction (TIMI) scores for major adverse cardiac events (MACEs) in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention.Methods:A retrospective analysis was conducted on 80 STEMI patients diagnosed at the Affiliated People's Hospital of Ningbo University from January 2018 to January 2022, all of whom received percutaneous coronary intervention. The patients were followed up for 1-15 months with a median time of 7.5 months. MACEs, mainly including target vessel reconstruction, recurrent myocardial infarction, new heart failure, malignant arrhythmia, and cardiac death, were recorded.Results:Of the 80 patients, MACEs occurred in 18 cases (22.5%, 18/80) after percutaneous coronary intervention. Univariate analysis found that patients in the MACEs group had an increase in age, multiple vessel lesions, stent implantation length, peak and duration of troponin I, and total ischemia time > 6 hours, which were significantly different from those in the non-MACEs group ( P < 0.05). The MACEs group showed a significant increase in GRACE score [(136.5 ± 30.4) scores], modified CADILLAC score [(11.2 ± 3.4) score], and TIMI score [(5.7 ± 1.5) scores] at 7 days after surgery. The percentage of patients with GRACE score high-risk [12/18 (66.67%)], CADILLAC score high-risk [13/18 (72.22%)], and TIMI score high-risk [11/18 (61.11%)] increased significantly ( χ2 = 23.22, 21.35, 24.42, all P < 0.05). Increasing age, total ischemia time > 6 hours, GRACE score high-risk, CADILLAC score high-risk and TIMI score high-risk were all independent risk factors for MACEs at 1-year follow-up in STEMI patients ( HR values were 1.079, 2.037, 3.562, 3.421, and 3.236, respectively). The receiver operating characteristic curve showed that the area under the curve of GRACE score high-risk, CADILLAC score high-risk, and TIMI score high-risk for predicting MACEs were 0.816, 0.823 and 0.803 respectively, with no statistically significant differences ( P > 0.05). Conclusion:The use of GRACE score, modified CADILLAC score, and TIMI score after percutaneous coronary intervention in STEMI patients has predictive value for major cardiac adverse events after percutaneous coronary intervention, and all three scores have good accuracy in predicting the risk of MACEs at 1-year follow-up.

Objective:To analyze the relationship between QRS-T angle and R/T ratio on electrocardiograms and cardiac function and major adverse cardiac events (MACEs) in patients with coronary heart disease, evaluate cardiac function in patients with coronary heart disease, and investigate the optimal method to predict the occurrence of MACEs.Methods:A total of 80 patients with coronary heart disease who were admitted to the Affiliated People's Hospital of Ningbo University from January 2019 to May 2022 were included in this study. Their cardiac function was evaluated. QRS-T angle and R/T ratio on electrocardiograms were compared among patients. The relationship between the QRS-T angle and R/T ratio on electrocardiograms and cardiac function in patients with chronic heart disease was analyzed using Spearman's correlation coefficient. All patients received 1 week of standardized treatment. These patients were divided into a MACE group and a non-MACE group according to whether they had a MACE. Univariate and multivariate logistic regression analyses were performed to determine the association of QRS-T angle and R/T ratio on electrocardiograms with the occurrence of MACE in patients with coronary heart disease.Results:The QRS-T angle and R/T ratio on electrocardiograms in patients with New York Heart Association (NYHA) class IV heart failure were (115.75 ± 6.83)° and (4.95 ± 0.89) respectively, which were significantly higher than those in patients with NYHA class II and III heart failure (both P < 0.05). The QRS-T angle and R/T ratio on electrocardiograms in patients with NYHA class III heart failure were higher than those in patients with NYHA class II heart failure (both P < 0.05). Spearman correlation coefficient analysis results showed that the QRS-T angle and R/T ratio on electrocardiograms were positively correlated with NYHA cardiac function classification (both P < 0.05). Univariate logistic regression analysis results showed that low left ventricular ejection fraction, high NYHA class, low-density lipoprotein level, large QRS-T angle, and R/T ratio were the risk factors for developing a MACE in patients with chronic heart disease (all P < 0.05). Conclusion:QRS-T angle and R/T ratio on electrocardiograms increase with the worsening of cardiac function, which is a risk factor for developing a MACE in patients with chronic heart disease. It can be used as an objective and effective factor to evaluate the actual condition of patients in the early diagnosis and treatment of chronic heart disease and provide data support for reasonably optimizing intervention strategies and improving therapeutic effects.