Risk Scoring System for Prognosis Estimation of Multivessel Disease Among Patients with ST-Segment Elevation Myocardial Infarction

Multivessel disease (MVD) is an independent risk factor for poor prognosis in acute myocardial infarction patients. Although several global risk scoring systems (RSS) are in use in clinical practice, there is no dedicated RSS for MVD in ST-segment elevation myocardial infarction (STEMI). The primary...

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Bibliographic Details
Published in:	International Heart Journal Vol. 60; no. 3; pp. 708 - 714
Main Authors:	Ryu, Kwang Sun, Bae, Jang-Whan, Jeong, Myung Ho, Cho, Myeong-Chan, Ryu, Keun-Ho, and other Korea Acute Myocardial Infarction Registry Investigators
Format:	Journal Article
Language:	English
Published:	Japan International Heart Journal Association 30-05-2019 Japan Science and Technology Agency
Subjects:	Acute Disease Aged Body Mass Index Body weight Cause of Death Cerebrovascular diseases Coronary Angiography - methods Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - epidemiology Coronary Artery Disease - mortality Creatinine Death Electrocardiography Female Heart Heart attacks Humans Male Medical prognosis Middle Aged Myocardial infarction Myocardial Infarction - epidemiology Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - surgery Obesity paradox Percutaneous coronary intervention Percutaneous Coronary Intervention - methods Prognosis Republic of Korea - epidemiology Risk Factors ST Elevation Myocardial Infarction - physiopathology Stents Stroke Volume - physiology Ventricle Ventricular Function, Left - physiology Republic of Korea Obesity paradox Percutaneous coronary intervention
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Summary:	Multivessel disease (MVD) is an independent risk factor for poor prognosis in acute myocardial infarction patients. Although several global risk scoring systems (RSS) are in use in clinical practice, there is no dedicated RSS for MVD in ST-segment elevation myocardial infarction (STEMI). The primary objective of this study is to develop a novel RSS to estimate the prognosis of patients with MVD in STEMI.We used the Korean Acute Myocardial Infarction Registry (KAMIR) to identify 2,030 STEMI patients with MVD who underwent appropriate percutaneous coronary intervention (PCI). Their data were analyzed to develop a new RSS. The prognostic power of this RSS was validated with 2,556 STEMI patients with MVD in the Korean Working Group on Myocardial Infarction Registry (KORMI).Six prognostic factors related to all-cause death in STEMI patients with MVD were age, serum creatinine, Killip Class, lower body weight, decrease in left ventricular ejection fraction, and history of cerebrovascular disease. The RSS for all-cause death was constructed using these risk factors and their statistical weight. The RSS had appropriate performance (c-index: 0.72) in the KORMI validation cohort.We developed a novel RSS that estimates all-cause death in the year following discharge for patients with MVD in STEMI appropriately treated by PCI. This novel RSS was transformed into a simple linear risk score to yield a simplified estimate prognosis of MVD among STEMI patients.
ISSN:	1349-2365 1349-3299
DOI:	10.1536/ihj.17-337