Prediction of cardiovascular mortality in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention.

Abstract:

OBJECTIVES:We analyzed a large patient group to develop a clinical risk score that could be applied to patients after primary percutaneous coronary intervention (PCI). METHODS:We reviewed 2529 consecutive patients treated with primary PCI for ST-elevation myocardial infarction between 2003 and 2008. All clinical, angiographic and follow-up data were retrospectively collected. Independent predictors of in-hospital cardiovascular mortality were determined by multivariate Cox regression analysis in all study patients. RESULTS:Five variables (Killip class 2/3, unsuccessful procedure, contrast-induced nephropathy, diabetes mellitus, and age >70 years) were selected from the initial multivariate model. Each of them was weighted with 1 point according to their respective odds ratio for in-hospital mortality and then total risk score was calculated for each patient with a range of 0-5 points. For simplicity, four strata of risk were defined (low risk, score 0; intermediate risk, score 1; high risk, score 2 and very high risk, score > or =3). Each risk strata had a strong association with in-hospital cardiovascular mortality (P<0.001 for trend). Moreover, among survivors after an in-hospital period, our risk score continued to be a powerful predictor of long-term mortality (P<0.001 for trend). CONCLUSION:In patients treated with primary PCI, a risk score, which was developed from five risk factors readily available after intervention, may be useful to predict in-hospital and long-term cardiovascular mortality.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Ergelen M,Gorgulu S,Uyarel H,Norgaz T,Ayhan E,Akkaya E,Soylu O,Ugur M,Tezel T

doi

10.1097/MCA.0b013e328333f528

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

207-11

issue

4

eissn

0954-6928

issn

1473-5830

journal_volume

21

pub_type

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