Background: Acute myocardial infarction (AMI) patients are at increased risk of death and recurrent ischemic events. We aimed to elaborate a risk score, based on the PEGASUS-TIMI 54 criteria, to predict mortality and non-fatal AMI in AMI patients. Methods: We retrospectively analyzed two prospectively collected AMI cohorts. We calculated a cut-off for the developed score and investigated its 1-year prognostic power in the derivation cohort (n = 1257). We externally validated our score in 913 AMI patients with a longer follow-up. Results: In the derivation cohort, the area under the curve of the score for the primary endpoint (1-year death and non-fatal AMI) was 0.70 (95% CI 0.65–0.76; P < 0.0001) and a cut-off of 6 was identified. The primary endpoint incidence in patients with a score above and below the cut-off was 12% and 3% (P < 0.001) in the derivation cohort and 16% and 6% in the validation cohort (P < 0.001). At multivariate analysis, the HR for the primary endpoint associated with a score ≥ 6 was 4.45 (P < 0.0001) in the derivation cohort and 2.86 (P < 0.0001) in the validation cohort. One-year major bleeding rate was low (<0.2% overall) and similar between risk groups. The prognostic performance of the score cut-off persisted beyond the first year after AMI in the validation cohort, maintaining a similar risk for death and non-fatal AMI (HR 3) at every following year. Conclusions: Our score, based on the PEGASUS-TIMI 54 criteria, may identify AMI patients at high risk of recurrent ischemic events, who might benefit from thorough preventive strategies.
A new score based on the PEGASUS-TIMI 54 criteria for risk stratification of patients with acute myocardial infarction / N. Cosentino, J. Campodonico, P. Faggiano, M. De Metrio, M. Rubino, V. Milazzo, M. Sbolli, C. Perego, M. Provini, A. Bonomi, F. Veglia, A.L. Bartorelli, G. Marenzi. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 278(2019), pp. 1-6.
|Titolo:||A new score based on the PEGASUS-TIMI 54 criteria for risk stratification of patients with acute myocardial infarction|
|Parole Chiave:||Acute myocardial infarction; PEGASUS-TIMI 54; Prognosis; Risk score; Cardiology and Cardiovascular Medicine|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.ijcard.2018.11.142|
|Appare nelle tipologie:||01 - Articolo su periodico|