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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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
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Language:English
Published: Japan International Heart Journal Association 30-05-2019
Japan Science and Technology Agency
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Abstract 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.
AbstractList 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.
Author and other Korea Acute Myocardial Infarction Registry Investigators
Jeong, Myung Ho
Ryu, Kwang Sun
Cho, Myeong-Chan
Bae, Jang-Whan
Ryu, Keun-Ho
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Snippet Multivessel disease (MVD) is an independent risk factor for poor prognosis in acute myocardial infarction patients. Although several global risk scoring...
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SubjectTerms 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
Title Risk Scoring System for Prognosis Estimation of Multivessel Disease Among Patients with ST-Segment Elevation Myocardial Infarction
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