Abstract 12826: Cardiovascular Mortality and Heart Failure Risk Score For Patients After ST-Segment Elevation Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: Data From the Leiden MISSION! Infarct Registry
Introduction: Risk scores developed for the prediction of an adverse outcome in patients after ST-segment elevation myocardial infarction (STEMI) have mostly addressed patients treated with thrombolysis and evaluated solely all-cause mortality as primary endpoint. Primary percutaneous coronary interventions (PCI) in STEMI patients have improved the outcome significantly and may have changed the relative contribution of different risk factors.
Methods: The patient population comprised 1484 consecutive patients admitted with STEMI treated with primary PCI. Clinical, angiographic and echocardiographic data that were obtained during the hospitalization were used to derive a risk score for the prediction of short-term (30-days) and long-term (1- and 4-years) cardiovascular mortality and hospitalization for heart failure.
Results: During a median follow-up duration of 30 months, 87 patients (6%) died from cardiovascular mortality or were hospitalized for heart failure. Multivariate Cox regression analyses identified age ≥70 years, Killip class ≥2, diabetes, left anterior descending coronary artery as culprit vessel, three vessel disease, peak cardiac troponin T level ≥3.5μ g/l, left ventricular ejection fraction ≤40% and heart rate at discharge ≥70bpm as relevant factors for the construction of the risk score. The discriminatory power of the model as assessed with the areas under the receiver operating characteristic curves was good (0.84, 0.83, 0.81 at 30-days, 1- and 4-years, respectively) and patients could be allocated to low (1%), intermediate (6%), or high (24%) risk categories.
Conclusions: In conclusion, eight parameters which are readily available during the hospitalization of STEMI patients treated with primary PCI can accurately stratify patients into low, intermediate and high risk categories.
- © 2011 by American Heart Association, Inc.