The risk stratification of patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
- VernacularTitle:PAMI评分用于急性ST段抬高心肌梗死介入治疗患者的预后评价
- Author:
Yiwen CHEN
;
Mingzhao QIN
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Angioplasty, transluminal, percutaneous coronary;
Risk factors;
Prognosis
- From:
Chinese Journal of Interventional Cardiology
2003;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the prognosis capacity of the Primary Angioplasty in Myocardial Infarction (PAMI) risk score for 6 months mortality in the clinical patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI), in addition to asses the incremental value of EF and multivessel disease for risk stratification. Methods Six clinical variables and their relative value of score derived from PAMI risk scoring system were used to determine individual's risk score. The patients with STEMI were evaluated during the in-hospital period and followed-up for a mean of (10.34?3.24) months for mortality. The p values were calculated using a Kruskal-Wallis H test for categorical variables when appropriate; otherwise Independent-samples test was used. Logistic regression examined the discriminant accuracy of the PAMI risk score to predict death and assessed the incremental value of the EF and multivessel disease. Results A 88.8% of patients (183 patients) finished the follow up of 6 months. The overall in-hospital mortality rate was 4.4%, 30-day mortality rate was 6% and 6 months mortality rate was 9.3%. Eighty-eight patients scored 0-2 points, 54 patients scored 3-5 points, 17 patients scored 6-8 points and 24 patients scored ≥9 points. The 6 months mortality were 1.1%,3.7%, 17.6% and 41.7% respectively. Logistic regression analysis indicated that multivessel disease is a risk factor (OR 10.189) and EF is a protected factor (OR 0.849) for 6 months mortality after PCI. Multivessel disease and EF provided incremental information over that provided by the PAMI risk score. Conclusion The PAMI risk score can be applied in early stage after PCI for mortality risk assessment for patients with STEMI. EF and multivessel disease also convey important prognostic information and should be included in risk stratification after STEMI.
