A new score based on the PEGASUS-TIMI 54 criteria for risk stratification of patients with acute myocardial infarction.
Int J Cardiol
; 278: 1-6, 2019 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-30528624
ABSTRACT
BACKGROUND:
Acute myocardial infarction (AMI) patients are at increased risk of death and recurrent ischemic events. We aimed to elaborate a risk score, based on the PEGASUS-TIMI 54 criteria, to predict mortality and non-fatal AMI in AMI patients.METHODS:
We retrospectively analyzed two prospectively collected AMI cohorts. We calculated a cut-off for the developed score and investigated its 1-year prognostic power in the derivation cohort (nâ¯=â¯1257). We externally validated our score in 913 AMI patients with a longer follow-up.RESULTS:
In the derivation cohort, the area under the curve of the score for the primary endpoint (1-year death and non-fatal AMI) was 0.70 (95% CI 0.65-0.76; Pâ¯<â¯0.0001) and a cut-off of 6 was identified. The primary endpoint incidence in patients with a score above and below the cut-off was 12% and 3% (Pâ¯<â¯0.001) in the derivation cohort and 16% and 6% in the validation cohort (Pâ¯<â¯0.001). At multivariate analysis, the HR for the primary endpoint associated with a scoreâ¯≥â¯6 was 4.45 (Pâ¯<â¯0.0001) in the derivation cohort and 2.86 (Pâ¯<â¯0.0001) in the validation cohort. One-year major bleeding rate was low (<0.2% overall) and similar between risk groups. The prognostic performance of the score cut-off persisted beyond the first year after AMI in the validation cohort, maintaining a similar risk for death and non-fatal AMI (HR 3) at every following year.CONCLUSIONS:
Our score, based on the PEGASUS-TIMI 54 criteria, may identify AMI patients at high risk of recurrent ischemic events, who might benefit from thorough preventive strategies.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
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Infarto do Miocárdio
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article