Bedside prediction of 9-year mortality after ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

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Abstract

BACKGROUND: Despite similar underlying pathogenesis, clinical features, and management of ST-segment elevation myocardial infarction (STEMI), the long-term prognosis of patients is highly variable. The ability to stratify an individual's long-term mortality risk could facilitate development of focused interventions aimed at reducing poor long-term outcomes. AIMS: This study aimed to develop and validate a simple risk score based on routinely collected data for all-cause and cardiovascular 9-year mortality in a homogeneous group of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). METHODS: All consecutive patients with STEMI treated with pPCI were randomly divided into 2 groups. The first group was called the building group and was used to develop logistic regression models that were converted into a simple risk scores that estimated all-cause and cardiovascular long-term mortality risk (ANIN risk score I and II, respectively) and subsequently validated in the second group, called the validating group. RESULTS: The 9-year follow-up data were available in 1059 out of 1064 patients with STEMI. We developed 4 independent risk scores with the highest predictive accuracy of ANIN risk score I. Validation cohorts identified 4 most important risk factors: age, renal dysfunction, Killip class, and thrombolysis in myocardial infarction flow. Low, intermediate, and high-risk subgroups were identified based on those factors with different long-term mortalities: 10%, 37%, and 71%, respectively. CONCLUSIONS: Long-term mortality after STEMI treated with pPCI can be accurately predicted using 4-variable bedside risk score, which is ready to calculate right after pPCI. Patients in the low-risk group have an excellent prognosis despite having experienced potentially lethal disease. Copyright by the Author(s), 2019.

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Polańska-Skrzypczyk, M., Karcz, M., Ruzyłło, W., & Witkowski, A. (2019). Bedside prediction of 9-year mortality after ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Kardiologia Polska, 77(7–8), 703–709. https://doi.org/10.33963/KP.14892

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