title: [Prognostic value of Charlson comorbidity index at 30 days and 1 year after acute myocardial infarction].
abstract: OBJECTIVE
  The Charlson comorbidity index (CCI), an indicator of comorbidity, has been used as an adjusting variable in multivariate models. Because of its prognostic value per se for cardiovascular complications after acute myocardial infarction (AMI), we sought to determine the predictive value of the CCI for all-cause mortality and recurrent AMI 30 days and 1 year after the index event.
  
  
  METHODS
  We analyzed 1035 consecutive patients admitted with the diagnosis of AMI (ST elevation=508 and non-ST elevation=527). The composite endpoint was determined after 30 days (13.9%) and 1 year (26.3%) of follow-up. The CCI was calculated on admission, and other variables with prognostic value were also recorded. CCI was stratified in 4 categories: 1: CCI=0 (control), 2: CCI=1, 3: CCI=2,4: CCI> or =3. Cox proportional risks analysis was used for the multivariate analysis, and the C-statistic was calculated to assess the discriminative power of the models.
  
  
  RESULTS
  Hazard ratios (95% CI) estimated for each category of CCI were: 2=1.69 (1.10-2.59), 3=1.78 (1.08-2.92) and 4=1.57 (0.87-2.83) at 30 days; 2=1.62 (1.18-2.23), 3=2.00 (1.39-2.89) and 4=2.24 (1.50-3.36) at 1 year. Comparisons with the C-statistic between the nested multivariate models (with and without CCI) yielded values of 0.765 vs 0.750 after 30 days, and 0.751 vs 0.735 after 1 year.
  
  
  CONCLUSIONS
  Our data indicate that CCI is an independent predictor of mortality or recurrent AMI 30 days and 1 year after the index AMI.
authors.affiliation: Servei de Cardiologia, Hospital Clínic i Universitari, Universitat de València, València, Spain. julionv@terra.es
authors.forename: Julio E
authors.initials: JE
authors.lastname: Núñez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Núñez
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.forename: Angel
authors.initials: A
authors.lastname: Llàcer
authors.forename: Vicent
authors.initials: V
authors.lastname: Bodí
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanjuán
authors.forename: María L
authors.initials: ML
authors.lastname: Blasco
authors.forename: Luciano
authors.initials: L
authors.lastname: Consuegra
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
vernacular_title: Papel del índice de Charlson en el pronóstico a 30 días y 1 año tras un infarto agudo de miocardio.