A New Risk Score to Predict 1-Year Mortality in Acute Non-ST Elevation Myocardial Infarction.
10.3904/kjm.2015.88.2.168
- Author:
Jin Hee PARK
1
;
In Hyae PARK
;
Myung Ho JEONG
;
Sook Ja LEE
;
Soo Yong JANG
;
Jae Young CHO
;
Hae Chang JEONG
;
Ki Hong LEE
;
Keun Ho PARK
;
Doo Sun SIM
;
Kye Hun KIM
;
Young Joon HONG
;
Hyung Wook PARK
;
Ju Han KIM
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Mortality;
Prognosis
- MeSH:
Biomarkers;
C-Reactive Protein;
Glomerular Filtration Rate;
Heart Rate;
Humans;
Jeollanam-do;
Mortality*;
Myocardial Infarction*;
Prognosis;
Retrospective Studies;
Risk Factors;
Stroke Volume
- From:Korean Journal of Medicine
2015;88(2):168-176
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Accurate risk stratification is important in the management of patients with acute myocardial infarction (AMI). This study aimed to develop a new assessment tool for the prediction of 1-year mortality in patients with AMI, including biochemical markers. The author developed a new assessment tool (new risk score) that takes biochemical markers into account for 1-year mortality in patients with non-ST elevation myocardial infarction (NSTEMI) and identifies the risk factors related to 1-year mortality. METHODS: A total of 1,427 patients (65 +/- 11.8 years of age, 985 males) who were admitted to the Chonnam National University Hospital with NSTEMI from November 2005 to March 2012 were retrospectively analyzed for score derivation. Multivariable Cox-regression analysis was used to select correlates of 1-year mortality that were subsequently weighted and integrated into an integer scoring system. RESULTS: Seven variables selected from the initial multivariate model were weighted proportionally to their respective hazard ratio for 1-year mortality; age > or = 65 years (2 points), N-terminal pro-brain natriuretic peptide (NT pro-BNP) > 991 pg/mL (1 point), baseline left ventricular ejection fraction < 40% (1 point), high sensitivity C-reactive protein (hs-CRP) > 3 mg/dL (1 point), glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 (1 point), heart rate > 82 beats/min (2 points), and final thrombolysis In myocardial infarction flow < 3 (2 points). CONCLUSIONS: In NSTEMI patients, our new score that incorporates seven risk factors accurately predicts the 1-year mortality. Additionally, the biochemical markers hs-CRP, NT pro-BNP, and GFR are reliable predictors of 1-year mortality.
