Abstract 19485: CANADA-AMI: A Simple Risk Score That Permits Rapid Stratification of Acute Myocardial Infarction
Background: In the management of acute myocardial infarction (AMI), a simple and easy-to-use risk score would be useful to identify high-risk patients who may benefit more from intensive treatment. We hypothesized that the C-AMI (for CANADA-AMI), a novel risk score, would be valuable for in-hospital and long-term risk stratification of AMI patients, both with and without ST-segment elevation.
Methods: The AMI-QUEBEC Study was an observational study of 1,655 AMI patients with ST-segment elevation (STEMI) in Quebec. The C-AMI risk score was developed from clinical characteristics independently associated with in-hospital mortality in the AMI-QUEBEC dataset. This risk score was defined as the sum of 4 dichotomous variables: age ≥75 years, Killip ≥2, initial heart rate >100/min and systolic blood pressure <100 mmHg. Each attribute contributes one point to the score ranging from 0–4. We tested the discriminant value of the C-AMI risk score in 5 Canadian cohorts of AMI patients.
Results: There were 29,943 AMI patients enrolled in the AMI-QUEBEC, Canadian ACS-1, ACS-2, GRACE, and EFFECT-1 studies. The mean age ranged from 62 to 67 years; 28% to 36% were women, and 51% had non-STEMI. The C-AMI risk score had good predictive values for both in-hospital and long-term total mortality in all cohorts. Patients with C-AMI score = 0 had ≤2% of in-hospital mortality and ≤5% of 1-year mortality. In-hospital mortality was ≥15% and 1-year mortality was ≥40% in patients with C-AMI scores ≥3. We summarized the c-statistics of the C-AMI in the different datasets in Table 1.
Conclusion: The C-AMI risk score had good predictive values for both in-hospital and long-term mortality in STEMI and non-STEMI. Considering its ease of use and simple computation, it may be particularly useful in pre-hospital settings. It can be complementary to other more complex risk scores for rapid stratification of AMI patients
- © 2010 by American Heart Association, Inc.