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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).
Am J Cardiol. 2012 Jan 15; 109(2):187-94.AJ

Abstract

The 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 the primary end point. Primary percutaneous coronary intervention in patients with STEMI has improved the outcome significantly and might have changed the relative contribution of different risk factors. Our patient population included 1,484 consecutive patients admitted with STEMI who had undergone primary percutaneous coronary intervention. The clinical, angiographic, and echocardiographic data obtained during hospitalization were used to derive a risk score for the prediction of short-term (30-day) and long-term (1- and 4-year) cardiovascular mortality and hospitalization for heart failure. During a median follow-up 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 the culprit vessel, 3-vessel disease, peak cardiac troponin T level ≥3.5 μg/L, left ventricular ejection fraction ≤40%, and heart rate at discharge ≥70 beats/min as relevant factors for the construction of the risk score. The discriminatory power of the model as assessed using the areas under the receiver operating characteristic curves was good (0.84, 0.83, and 0.81 at 30 days and 1 and 4 years, respectively), and the patients could be allocated to low-, intermediate-, or high-risk categories with an event rate of 1%, 6%, and 24%, respectively. In conclusion, the current risk model demonstrates for the first time that 8 parameters readily available during the hospitalization of patients with STEMI treated with primary percutaneous coronary intervention can accurately stratify patients at long-term follow-up (≤4 years after the index infarction) into low-, intermediate-, and high-risk categories.

Authors+Show Affiliations

Department of Cardiology, Leiden University Medical Center, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22244127

Citation

Antoni, M Louisa, et al. "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)." The American Journal of Cardiology, vol. 109, no. 2, 2012, pp. 187-94.
Antoni ML, Hoogslag GE, Boden H, et al. 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). Am J Cardiol. 2012;109(2):187-94.
Antoni, M. L., Hoogslag, G. E., Boden, H., Liem, S. S., Boersma, E., Fox, K., Schalij, M. J., Bax, J. J., & Delgado, V. (2012). 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). The American Journal of Cardiology, 109(2), 187-94. https://doi.org/10.1016/j.amjcard.2011.08.029
Antoni ML, et al. 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). Am J Cardiol. 2012 Jan 15;109(2):187-94. PubMed PMID: 22244127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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). AU - Antoni,M Louisa, AU - Hoogslag,Georgette E, AU - Boden,Helèn, AU - Liem,Su San, AU - Boersma,Eric, AU - Fox,Kim, AU - Schalij,Martin J, AU - Bax,Jeroen J, AU - Delgado,Victoria, PY - 2011/05/05/received PY - 2011/08/18/revised PY - 2011/08/18/accepted PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2012/3/1/medline SP - 187 EP - 94 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 109 IS - 2 N2 - The 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 the primary end point. Primary percutaneous coronary intervention in patients with STEMI has improved the outcome significantly and might have changed the relative contribution of different risk factors. Our patient population included 1,484 consecutive patients admitted with STEMI who had undergone primary percutaneous coronary intervention. The clinical, angiographic, and echocardiographic data obtained during hospitalization were used to derive a risk score for the prediction of short-term (30-day) and long-term (1- and 4-year) cardiovascular mortality and hospitalization for heart failure. During a median follow-up 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 the culprit vessel, 3-vessel disease, peak cardiac troponin T level ≥3.5 μg/L, left ventricular ejection fraction ≤40%, and heart rate at discharge ≥70 beats/min as relevant factors for the construction of the risk score. The discriminatory power of the model as assessed using the areas under the receiver operating characteristic curves was good (0.84, 0.83, and 0.81 at 30 days and 1 and 4 years, respectively), and the patients could be allocated to low-, intermediate-, or high-risk categories with an event rate of 1%, 6%, and 24%, respectively. In conclusion, the current risk model demonstrates for the first time that 8 parameters readily available during the hospitalization of patients with STEMI treated with primary percutaneous coronary intervention can accurately stratify patients at long-term follow-up (≤4 years after the index infarction) into low-, intermediate-, and high-risk categories. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/22244127/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__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(11)02745-7 DB - PRIME DP - Unbound Medicine ER -