A new risk score system for the assessment of clinical outcomes in patients with non-ST-segment elevation myocardial infarction.
OBJECTIVE
Prediction for long-term clinical outcomes in patients with non-ST elevation acute coronary syndrome is important as well as early risk stratification. The aim of this study is to develop a simple assessment tool for better early bedside risk stratification for both short- and long-term clinical outcomes.


METHODS
2148 patients with non-ST-segment elevation myocardial infarction (NSTEMI) (64.9±12.2 years, 35.0% females) were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR). A new risk score was constructed using the variables related to one year mortality: TIMI risk index (17.5-30: 1 point, >30: 2 points), Killip class (II: 1 point, >II: 2 points) and serum creatinine (≥1.5 mg/dL: 1 point), based on the multivariate-adjusted risk relationship. The new risk score system was compared with the Global Registry of Acute Coronary Events (GRACE) and TIMI risk scores during a 12-month clinical follow-up.


RESULTS
During a one year follow-up, all causes of death occurred in 362 patients (14.3%), and 184 (8.6%) patients died in the hospital. The new risk score showed good predictive value for one year mortality. The accuracy for in-hospital and one year post-discharge mortality rates, the new risk score demonstrated significant differences in predictive accuracy when compared with TIMI and GRACE risk scores.


CONCLUSIONS
A new risk score in the present study provides simplicity with accuracy simultaneously for early risk stratification, and also could be a powerful predictive tool for long-term prognosis in NSTEMI.
Kim
Hyun Kuk
HK
Chonnam National University Hospital, South Korea.
Jeong
Myung Ho
MH
Ahn
Youngkeun
Y
Kim
Jong Hyun
JH
Chae
Shung Chull
SC
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Seong
In Whan
IW
Hong
Taek Jong
TJ
Choi
Dong Hoon
DH
Cho
Myeong Chan
MC
Kim
Chong Jin
CJ
Seung
Ki Bae
KB
Chung
Wook Sung
WS
Jang
Yang Soo
YS
Rha
Seung Woon
SW
Bae
Jang Ho
JH
Cho
Jeong Gwan
JG
Park
Seung Jung
SJ
D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis