PAMI risk score for mortality prediction in acute myocardial indarction treated with primary angioplasty.
OBJECTIVE
Based on the PAMI 1 and 2, AIR PAMI, and STENT PAMI trials, a risk score to predict mortality in patients undergoing primary angioplasty was recently proposed--the PAMI risk score. It includes only 6 parameters. As one of the first tools available to predict mortality in this group of patients, it results from controlled trials, with restricted inclusion criteria. It was our objective to evaluate how the PAMI risk score applies to "real world" patients.


METHODS
149 patients (mean age 58.2 +/- 13.6 years, 113 male) undergoing primary angioplasty were included. The PAMI risk score was applied and the patients were divided in 3 groups: 0 to 2 points (group A), 3 to 6 points (group B) and > or =7 points (group C).


RESULTS
Sixty-eight patients (46%) were included in group A, 41 (27%) in group B and 40 (27%) in group C. There were no significant differences in pain-to-balloon times between the 3 groups. Immediate mortality (0%, 2.4% and 15%: p = 0.001), in-hospital mortality (2.9%, 7.3% and 37.5%; p < 0.001), 30-day mortality (2.9%, 7.3% and 37.5%; p < 0.001) and 6-month mortality (4.4%, 14.6% and 45%; p < 0.001) were significantly different between the 3 groups.


CONCLUSIONS
The PAMI risk score is a simple prognostic tool, with parameters that can be easily acquired, enabling reliable prediction of immediate, in-hospital, 30-day and 6-month mortality in patients with acute myocardial infarction treated with primary angioplasty.
Serviço de Cardiologia do Hospital Fernando Fonseca, Amadora, Portugal. sbcbaptista@sapo.pt
Sérgio Bravo
SB
Baptista
Pedro
P
Farto e Abreu
J Rodrigues
JR
Loureiro
Boban
B
Thomas
Maura
M
Nédio
Sofia
S
Gago
Rafael
R
Ferreira
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment