Predictive value of the combination of age, creatinine, and ejection fraction score and diabetes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

被引:14
作者
Gao, Side [1 ]
Liu, Qingbo [1 ]
Ding, Xiaosong [1 ]
Chen, Hui [1 ]
Zhao, Xueqiao [3 ]
Li, Hongwei [1 ,2 ]
机构
[1] Capital Med Univ, Beijing Friendship Hosp, Ctr Cardiovasc, Dept Cardiol, 95 Yongan Rd, Beijing 100050, Peoples R China
[2] Beijing Key Lab Metab Disorders Related Cardiovas, Beijing, Peoples R China
[3] Univ Washington, Div Cardiol, Clin Atherosclerosis Res Lab, Seattle, WA 98195 USA
基金
中国国家自然科学基金; 北京市自然科学基金;
关键词
one-year outcomes; percutaneous coronary intervention; predictive value; ST-segment elevation myocardial infarction; RISK STRATIFICATION; MORTALITY RISK; SYNTAX SCORE; ROC CURVE; GUIDELINES; SURGERY; AREA; ACEF;
D O I
10.1097/MCA.0000000000000791
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: This study investigated whether the age, creatinine, and ejection fraction (ACEF) score [age (years) /ejection fraction (%) +1 (if creatinine>176 mu mol/L)] could predict 1-year outcomes following ST-segment elevation myocardial infarction after percutaneous coronary intervention, and whether accuracy could be improved by establishing novel ACEF-derived risk models. Methods: A total of 1146 patients were included. The study endpoint was 1-year major adverse cardio-cerebrovascular events, including all-cause death, nonfatal myocardial infarction, unplanned revascularization, and nonfatal stroke. Accuracy was defined with area under the curve by receiver-operating characteristic curve analysis. Results: The incidence of 1-year major adverse cardio-cerebrovascular event increased with the rising age, creatinine, and ejection fraction score tertiles (4.8%, 8.4%, and 15.2%, P < 0.001 for all). Higher ACEF score was significantly associated with an increased risk of the endpoint in overall (odds ratio = 3.75, 95% confidence interval, 2.44-5.77, P < 0.001) and in subgroups (all P < 0.05). The accuracy of the ACEF score was equivalent to the other complex risk scores. The combination of ACEF, and diabetes (ACEF-diabetes score) yielded a superior discriminatory ability than the original ACEF score (increase in C-statistic from 0.67 to 0.71, P = 0.048; continuous net reclassification improvement = 51.9%, 95% confidence interval, 33.4-70.5%, P < 0.001; integrated discrimination improvement = 0.020, 95% confidence interval, 0.011-0.030, P < 0.001). Conclusions: The simplified ACEF score performed well in predicting 1-year outcomes in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention. The novel ACEF-diabetes score provided a better predictive value and thus may help stratify high-risk patients and potentially facilitate decision making.
引用
收藏
页码:109 / 117
页数:9
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