TY - JOUR
T1 - A new post-PCI scoring system for in-hospital mortality in STEMI patients
AU - Chiostri, Marco
AU - Valente, Serafina
AU - Crudeli, Elena
AU - Giglioli, Cristina
AU - Gensini, Gian Franco
PY - 2010/10
Y1 - 2010/10
N2 - Objective: To develop a scoring system for predicting in-hospital mortality among ST-elevation myocardial infarction (STEMI) patients submitted to percutaneous intervention (PCI) on intensive cardiac care unit admission by using early and readily available clinical, angiographic and laboratory data. Design: Prospective monocentric observational study in which we used discriminant analysis to develop a final scoring system, with prospective validation. Setting: Intensive cardiac care unit in Florence, a tertiary center. Population: Five hundred and fifty-eight unselected patients with STEMI (group A) consecutively admitted from 1 January 2004 to 31 December 2006. A control group (group B) comprising 183 STEMI patients admitted from 1 January 2007 to 30 September 2007. Main outcomes and measures: In-hospital death. Results: In group A the discriminant variables were admission Killip class, admission lactic acid, admission ejection fraction, admission troponin I (TnI), admission hemoglobin (Hb), ST-segment reduction post-PCI, systolic blood pressure on admission and chronic renal failure. We elaborated a scoring system, the Florence admission STEMI risk score, which shows an agreement of 95.7% between the observed and the estimated outcome on a statistical basis in the survival and death subgroups. We applied this score to group B (C statistics = 0.986). Conclusion: The Florence admission STEMI risk score incorporates anamnestic (chronic renal failure), laboratory (lactic acid, TnI and Hb), procedural and post-procedural data (ST-segment reduction post-PCI, Killip class) as well as data strictly related to infarct size (ejection fraction, TnI). This scoring system is likely to be a simple and practical tool at the bedside for risk evaluation in patients with STEMI submitted to primary PCI.
AB - Objective: To develop a scoring system for predicting in-hospital mortality among ST-elevation myocardial infarction (STEMI) patients submitted to percutaneous intervention (PCI) on intensive cardiac care unit admission by using early and readily available clinical, angiographic and laboratory data. Design: Prospective monocentric observational study in which we used discriminant analysis to develop a final scoring system, with prospective validation. Setting: Intensive cardiac care unit in Florence, a tertiary center. Population: Five hundred and fifty-eight unselected patients with STEMI (group A) consecutively admitted from 1 January 2004 to 31 December 2006. A control group (group B) comprising 183 STEMI patients admitted from 1 January 2007 to 30 September 2007. Main outcomes and measures: In-hospital death. Results: In group A the discriminant variables were admission Killip class, admission lactic acid, admission ejection fraction, admission troponin I (TnI), admission hemoglobin (Hb), ST-segment reduction post-PCI, systolic blood pressure on admission and chronic renal failure. We elaborated a scoring system, the Florence admission STEMI risk score, which shows an agreement of 95.7% between the observed and the estimated outcome on a statistical basis in the survival and death subgroups. We applied this score to group B (C statistics = 0.986). Conclusion: The Florence admission STEMI risk score incorporates anamnestic (chronic renal failure), laboratory (lactic acid, TnI and Hb), procedural and post-procedural data (ST-segment reduction post-PCI, Killip class) as well as data strictly related to infarct size (ejection fraction, TnI). This scoring system is likely to be a simple and practical tool at the bedside for risk evaluation in patients with STEMI submitted to primary PCI.
KW - Mortality
KW - percutaneous intervention
KW - scoring system
KW - ST-elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=77956268349&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956268349&partnerID=8YFLogxK
U2 - 10.2459/JCM.0b013e328339d910
DO - 10.2459/JCM.0b013e328339d910
M3 - Article
C2 - 20479658
AN - SCOPUS:77956268349
VL - 11
SP - 733
EP - 738
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 10
ER -