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KMID : 0882420150880020168
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Korean Journal of Medicine
2015 Volume.88 No. 2 p.168 ~ p.176
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A New Risk Score to Predict 1-Year Mortality in Acute Non-ST Elevation Myocardial Infarction
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Park Jin-Hee
Park In-Hyae
Jeong Myung-Ho
Lee Sook-Ja
Jang Soo-Young
Cho Jae-Yeong
Jeong Hae-Chang
Lee Ki-Hong
Park Keun-Ho
Sim Doo-Sun
Kim Kye-Hun
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
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Abstract
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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 ≥ 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.
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KEYWORD
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Myocardial infarction, Mortality, Prognosis
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