Medicinski Podmladak (Jan 2018)
Comparison of predictive value of five risk scores in patients with myocardial infarction treated with primary percutaneous coronary intervention
Abstract
Introduction: Mortality of patients with acute myocardial infarction (AMI) treated by primary PCI (pPCI) is relatively high when short and long term-outcomes are concerned, despite the progress of standard of care. The stratification of patients according to risk of death is of great diagnostic, therapeutic and prognostic significance. Several risk scores have been developed, however only a few studies so far investigated the efficacy of these scores in predicting long-term mortality. Aim: The aim of study was to compare the predictive value of five risk scores, regarding long-term mortality among patients with AMI treated with pPCI in the Clinical Center of Serbia. Materials and methods: We performed a retrospective study that included 497 consecutive patients with a diagnosis of AMI treated with pPCI in 2012. For every patient, the value of CADILLAC, ZWOLLE, ACEF, TIMI and PAMI scores was calculated. Prognostic ability of risk scores was compared by area under (AUC) the ROC (receiver-operating characteristics) curve. Results: Population consisted of 497 patients with AMI treated with pPCI, average age 61.07 ± 11.55 out of which 67.4 % were male. Cumulative mortality rate at 30 days, 1, 2 and 3 years of clinical follow-up amounted to 1.5 %, 5.2 %, 9.5 % and 10.5 %, respectively. CADILLAC score performed very well predicting one-year (AUC 0.822), two-years (0.819) and three-year mortality (0.815). The good predictive value, although significantly less accurate compared to the CADILLAC score, was shown for ZWOLLE and ACEF score in predicting one-year (0.742; 0.742), two-years (0.728; 0.741) as well as the three-year mortality (0.721; 0.743) respectively, while the PAMI and TIMI scores obtained the lowest predictive values for one-year (0.680; 0.605), two-years (0.706; 0.599), and for the three-year mortality (0.700; 0.590), respectively. Conclusion: CADILLAC risk score showed the best predictive ability regarding mortality up to three years in a population of AMI patients treated with pPCI.
