Abstract
Background: The aims of the study were to evaluate the performance of the Duke Treadmill Score (DTS) and the Veteran Affairs Medical Center Score (VAMCS) in predicting 6-month death in GISSI-2 study survivors of acute myocardial infarction treated with thrombolytic agents, and to develop a simple predictive scoring system from the same database. Methods: Patients of the GISSI-2 Study (n = 6251) performed a maximal symptom-limited exercise test 1 month after myocardial infarction. We calculated for each patient the DTS and the VAMCS. Based on the coefficients of a multivariate analysis of our database, we developed a simple predictive scoring system and performed an internal validation. The prognostic value of each scoring system was assessed by multivariate analysis. Results: Six-month mortality rates in the subgroups of each scoring system were as follows: DTS: low risk 0.6%, moderate risk 1.8%, high risk 3.4% (P ≤ .0001); VAMCS: low risk 0.6%, moderate risk 1.9%, high risk 4.7% (P ≤ .0001); GISSI-2 Index: low risk 0.5%, moderate risk 1.9%, high risk 6.1% (P ≤ .0001). The results of multivariate analysis (relative risk [RR] and 95% CI) were as follows: DTS: moderate risk 2.50 (1.47-12.59), high risk 5.13 (3.61-15.55); VAMCS: moderate risk 2.65 (1.53-4.59), high risk 5.97 (3.10-11.49); GISSI-2 Index: moderate risk 3.16 (1.81-5.52), high risk 8.65 (4.36-17.18). Conclusions: The use of ergometric-derived prognostic score systems in a population of survivors of acute myocardial infarction treated with thrombolytic drugs distinguishes subgroups at different risks of death and allows an appropriate recourse to more costly procedures.
| Original language | English |
|---|---|
| Pages (from-to) | 475-483 |
| Number of pages | 9 |
| Journal | American Heart Journal |
| Volume | 145 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2003 |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Ergometric score systems after myocardial infarction : Prognostic performance of the Duke Treadmill Score, veterans administration medical center score, and of a novel score system, GISSI-2 index, in a cohort of survivors of acute myocardial infarction. / Villella, Massimo; Villella, Alessandro; Santoro, Luigi; Santoro, Eugenio; Franzosi, Maria Grazia; Maggioni, Aldo Pietro.
In: American Heart Journal, Vol. 145, No. 3, 01.03.2003, p. 475-483.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ergometric score systems after myocardial infarction
T2 - Prognostic performance of the Duke Treadmill Score, veterans administration medical center score, and of a novel score system, GISSI-2 index, in a cohort of survivors of acute myocardial infarction
AU - Villella, Massimo
AU - Villella, Alessandro
AU - Santoro, Luigi
AU - Santoro, Eugenio
AU - Franzosi, Maria Grazia
AU - Maggioni, Aldo Pietro
PY - 2003/3/1
Y1 - 2003/3/1
N2 - Background: The aims of the study were to evaluate the performance of the Duke Treadmill Score (DTS) and the Veteran Affairs Medical Center Score (VAMCS) in predicting 6-month death in GISSI-2 study survivors of acute myocardial infarction treated with thrombolytic agents, and to develop a simple predictive scoring system from the same database. Methods: Patients of the GISSI-2 Study (n = 6251) performed a maximal symptom-limited exercise test 1 month after myocardial infarction. We calculated for each patient the DTS and the VAMCS. Based on the coefficients of a multivariate analysis of our database, we developed a simple predictive scoring system and performed an internal validation. The prognostic value of each scoring system was assessed by multivariate analysis. Results: Six-month mortality rates in the subgroups of each scoring system were as follows: DTS: low risk 0.6%, moderate risk 1.8%, high risk 3.4% (P ≤ .0001); VAMCS: low risk 0.6%, moderate risk 1.9%, high risk 4.7% (P ≤ .0001); GISSI-2 Index: low risk 0.5%, moderate risk 1.9%, high risk 6.1% (P ≤ .0001). The results of multivariate analysis (relative risk [RR] and 95% CI) were as follows: DTS: moderate risk 2.50 (1.47-12.59), high risk 5.13 (3.61-15.55); VAMCS: moderate risk 2.65 (1.53-4.59), high risk 5.97 (3.10-11.49); GISSI-2 Index: moderate risk 3.16 (1.81-5.52), high risk 8.65 (4.36-17.18). Conclusions: The use of ergometric-derived prognostic score systems in a population of survivors of acute myocardial infarction treated with thrombolytic drugs distinguishes subgroups at different risks of death and allows an appropriate recourse to more costly procedures.
AB - Background: The aims of the study were to evaluate the performance of the Duke Treadmill Score (DTS) and the Veteran Affairs Medical Center Score (VAMCS) in predicting 6-month death in GISSI-2 study survivors of acute myocardial infarction treated with thrombolytic agents, and to develop a simple predictive scoring system from the same database. Methods: Patients of the GISSI-2 Study (n = 6251) performed a maximal symptom-limited exercise test 1 month after myocardial infarction. We calculated for each patient the DTS and the VAMCS. Based on the coefficients of a multivariate analysis of our database, we developed a simple predictive scoring system and performed an internal validation. The prognostic value of each scoring system was assessed by multivariate analysis. Results: Six-month mortality rates in the subgroups of each scoring system were as follows: DTS: low risk 0.6%, moderate risk 1.8%, high risk 3.4% (P ≤ .0001); VAMCS: low risk 0.6%, moderate risk 1.9%, high risk 4.7% (P ≤ .0001); GISSI-2 Index: low risk 0.5%, moderate risk 1.9%, high risk 6.1% (P ≤ .0001). The results of multivariate analysis (relative risk [RR] and 95% CI) were as follows: DTS: moderate risk 2.50 (1.47-12.59), high risk 5.13 (3.61-15.55); VAMCS: moderate risk 2.65 (1.53-4.59), high risk 5.97 (3.10-11.49); GISSI-2 Index: moderate risk 3.16 (1.81-5.52), high risk 8.65 (4.36-17.18). Conclusions: The use of ergometric-derived prognostic score systems in a population of survivors of acute myocardial infarction treated with thrombolytic drugs distinguishes subgroups at different risks of death and allows an appropriate recourse to more costly procedures.
UR - http://www.scopus.com/inward/record.url?scp=0037352184&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037352184&partnerID=8YFLogxK
U2 - 10.1067/mhj.2003.162
DO - 10.1067/mhj.2003.162
M3 - Article
C2 - 12660671
AN - SCOPUS:0037352184
VL - 145
SP - 475
EP - 483
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -