title: The prognostic value of peripheral artery diseases in patients with ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  To evaluate the clinical and prognostic role of haemodynamically insignificant stenosis of the extracranial arteries (ECA) and lower extremity arteries (LEA) among patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  The study sample consisted of 423 patients with STEMI who were consecutively admitted to the Kemerovo Cardiological Centre.
  
  
  RESULTS
  The prevalence of polyvascular diseases (PVD), as defined by an increased intima-media thickness (IMT) of the common carotid artery or by stenosis of the ECA or LEA, was 95%. Among patients with ECA or LEA, the case fatality rate of those with stenosis with occlusion of less than 30% of the vessel lumen was 5.7%, whereas the case fatality rate among patients with stenosis with occlusion of more than 30% of the vessel lumen was 15.1% (χ(2) = 13.68, P = 0.003). Using the GRACE score model, together with the determination of additional factors (congestive heart failure, PVD, prior stroke, and smoking status), we developed an improved model (KemScore) for death risk stratification for a 12-month period. The value of the AUC for our model (KemScore) was 0.83 (95% CI = 0.76-0.90), which was significantly higher than the initial GRACE score value of 0.71 (95% CI = 0.63-0.79).
authors.affiliation: Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002, Russia ; Department of Cardiology and Cardiovascular Surgery, Kemerovo State Medical Academy, Sosnovy Bulvar 6, Kemerovo 650002, Russia.
authors.forename: Olga L
authors.initials: OL
authors.lastname: Barbarash
authors.affiliation: Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002, Russia ; Department of Cardiology and Cardiovascular Surgery, Kemerovo State Medical Academy, Sosnovy Bulvar 6, Kemerovo 650002, Russia.
authors.forename: Mikhail V
authors.initials: MV
authors.lastname: Zykov
authors.affiliation: Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002, Russia ; Department of Cardiology and Cardiovascular Surgery, Kemerovo State Medical Academy, Sosnovy Bulvar 6, Kemerovo 650002, Russia.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Pecherina
authors.affiliation: Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002, Russia ; Department of Cardiology and Cardiovascular Surgery, Kemerovo State Medical Academy, Sosnovy Bulvar 6, Kemerovo 650002, Russia.
authors.forename: Vasily V
authors.initials: VV
authors.lastname: Kashtalap
authors.affiliation: Kemerovo Cardiological Centre, Sosnovy Bulvar 6, Kemerovo 650002, Russia.
authors.forename: Leonid S
authors.initials: LS
authors.lastname: Barbarash
authors.affiliation: Department of Epidemiology, Kemerovo State Medical Academy, Voroshilova Street 22a, Kemerovo 650002, Russia.
authors.forename: Anton G
authors.initials: AG
authors.lastname: Kutikhin
mesh_terms: D019540:Area Under Curve; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000473:pathology; D058729:Peripheral Arterial Disease / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index