Predictive value of acef score for clinical prognosis of elderly patients with st-segment elevation myocardial infarction after percutaneous coronary intervention

Abstract

Background: To investigate the predictive value of the age, creatinine, and ejection fraction (ACEF) score for cardiac death in patients aged ≥75 years diagnosed with acute ST-segment elevation myocardial infarction (STEMI) at 1 month and 1 year after emergency percutaneous coronary intervention (PCI). Methods: A total of 360 patients with STEMI undergoing emergency PCI in the Department of Cardiology of Anhui Provincial Hospital from January 2013 to April 2018 were consecutively recruited. The primary endpoint event was cardiac death at postoperative 1 month and 1 year. The ROC curve was utilized to evaluate ACEF scoring system and predict cardiac death rate. Results: According to ACEF score upon admission, 360 patients were divided into low-to-intermediate risk group (n=80) with ACEF score of 0.99–1.27 (1.18±0.07) and high-risk group (n=280) with ACEF score of 1.28–4.14 (1.83±0.51). The age, left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), heart rate and the proportion of complete revascularization in the high-risk group were significantly higher than those in low-to-intermediate risk group (all P<0.05). The area under ROC curve for ACEF scoring system to predict cardiac death at 1 month and 1 year following PCI was 0.809 and 0.763, respectively. Conclusions: ACEF value upon admission can predict the cardiac death rate at 1 month and 1 year after emergency PCI in STEMI patients aged ≥75 years old.