Risk stratification in patients with acute myocardial infarction using several scores
Abstract
Introduction: There are several scores worldwide for risk stratification in patients with myocardial infarction, but the “ideal score” has not yet been found.
Objective: To determine the discriminatory capacity of GRACE, TIMI Risk Score, InTIME and ICR scores for in-hospital mortality due to acute myocardial infarction.
Method: A prospective study was carried out in the Department of Cardiology of the Hospital General Docente Dr. Ernesto Guevara de la Serna of Las Tunas, Cuba, between 2018 and 2019. The study’s population consisted of 452 patients admitted in the first 24 hours after myocardial infarction, and the sample consisted of 430 cases from which all the variables under study could be collected. Descriptive statistics were used. Sensitivity, specificity and area under the curve were determined to be able to determine the discriminatory capacity of the risk scores as well.
Results: The 70% of the deceased patients were male and their mean age was 10 years older than in the patients discharged alive. High blood pressure was the most frequent associated risk factor in both deceased patients (90%) and in those who left the hospital alive (73.4%). The 70% of deaths had certain degree of left ventricular systolic dysfunction. The area under the curve of ICR, InTIME and GRACE scores was of 0.683; 0.681 and 0.662 respectively. TIMI Risk Score had an area under the curve of 0.598.
Conclusions: ICR, InTime and GRACE scores had poor predictive capacity for in-hospital mortality. TIMI Risk Score had a very poor predictive capacity.
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References
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