MỐI LIÊN QUAN GIỮA XÉT NGHIỆM PROTHROMBIN LÚC NHẬP VIỆN VÀ BIẾN CỐ TIM MẠCH 30 NGÀY Ở BỆNH NHÂN HỘI CHỨNG VÀNH CẤP CAN THIỆP MẠCH VÀNH QUA DA

Abstract

Background: Acute coronary syndrome (ACS) is a critical manifestation of coronary artery disease involving endothelial dysfunction, inflammation, and thrombosis. Prothrombin time (PT), reflecting the extrinsic coagulation pathway, may be linked to adverse outcomes in acute cardiovascular conditions.

Objective: To investigate the association between admission PT and 30-day cardiovascular events in ACS patients undergoing percutaneous coronary intervention. Methods: A prospective observational study was conducted on 188 ACS patients treated with PCI. Patients were categorized into Group I (PT < 14 seconds) and Group II (PT ≥ 14 seconds) based on admission PT. Results: The 30-day mortality rate was significantly higher in Group II (15.2%) compared to Group I (3.3%) (p = 0.017). No significant differences were observed between groups in terms of rehospitalization, stroke, recurrent myocardial infarction, or bleeding. The MACE rate was higher in Group II (21.2% vs. 15.7%, p = 0.3). Univariate Cox regression showed each 1-second increase in PT was associated with a 1.68-fold increase in mortality (p < 0.01); multivariate analysis confirmed a 1.54-fold increase (95% CI: 1.1–2.1, p < 0.01). PT significantly improved the predictive power of a mortality model, raising the AUC from 0.712 to 0.726 (p = 0.0118). Conclusion: Prolonged admission PT is an independent predictor of 30-day mortality in ACS patients undergoing PCI and improves the performance of multivariable prognostic models.