A New Risk Score to Predict 1-Year Mortality in Acute Non-ST Elevation Myocardial Infarction / 대한내과학회지

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 3 mg/dL (1 point), glomerular filtration rate (GFR) 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.