TY - JOUR T1 - Predictors of one-year mortality at hospital discharge after acute coronary syndromes: A new risk score from the EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients) study. AU - Pocock,Stuart, AU - Bueno,Héctor, AU - Licour,Muriel, AU - Medina,Jesús, AU - Zhang,Lin, AU - Annemans,Lieven, AU - Danchin,Nicholas, AU - Huo,Yong, AU - Van de Werf,Frans, Y1 - 2014/10/09/ PY - 2014/10/11/entrez PY - 2014/10/11/pubmed PY - 2016/9/17/medline KW - Acute coronary syndrome KW - hospital discharge KW - mortality KW - prognostic model KW - risk score SP - 509 EP - 17 JF - European heart journal. Acute cardiovascular care JO - Eur Heart J Acute Cardiovasc Care VL - 4 IS - 6 N2 - AIMS: A reliable prediction tool is needed to identify acute coronary syndrome (ACS) patients with high mortality risk after their initial hospitalization. METHODS: EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients: NCT01171404) is a prospective cohort study of 10,568 consecutive hospital survivors after an ACS event (4943 ST-segment elevation myocardial infarction (STEMI) and 5625 non-ST-elevation ACS (NSTE-ACS)). Of these cases, 65.1% underwent percutaneous coronary intervention (PCI) and 2.5% coronary artery bypass graft (CABG). Post-discharge mortality was recorded for up to two years. From over 50 potential predictor variables a new risk score for one-year mortality was developed using forward stepwise Cox regression, and examined for goodness-of-fit, discriminatory power, and external validation. RESULTS: A total of 407 patients (3.9%) died within one year of discharge. We identified 12 highly significant independent predictors of mortality (in order of predictive strength): age, lower ejection fraction, poorer EQ-5D quality of life, elevated serum creatinine, in-hospital cardiac complications, chronic obstructive pulmonary disease, elevated blood glucose, male gender, no PCI/CABG after NSTE-ACS, low hemoglobin, peripheral artery disease, on diuretics at discharge. When combined into a new risk score excellent discrimination was achieved (c-statistic=0.81) and this was also validated on a large similar cohort (9907 patients) in Asia (c=0.78). For both STEMI and NSTE-ACS there was a steep gradient in one-year mortality ranging from 0.5% in the lowest quintile to 18.2% in the highest decile. NSTE-ACS contributes over twice as many high-risk patients as STEMI. CONCLUSIONS: Post-discharge mortality for ACS patients remains of concern. Our new user-friendly risk score available on www.acsrisk.org can readily identify who is at high risk. SN - 2048-8734 UR - https://www.unboundmedicine.com/medline/citation/25301783/Predictors_of_one_year_mortality_at_hospital_discharge_after_acute_coronary_syndromes:_A_new_risk_score_from_the_EPICOR__long_tErm_follow_uP_of_antithrombotic_management_patterns_In_acute_CORonary_syndrome_patients__study_ L2 - https://journals.sagepub.com/doi/10.1177/2048872614554198?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -