Incorporating the erythrocyte sedimentation rate for enhanced accuracy of the global registry of acute coronary event score in patients with ST-segment elevated myocardial infarction

The aim of the study was to determine the prognostic criteria for the severity of postinfarction (within 12 months) course in patients of working age who underwent Q-myocardial infarction (Q-MI), having studied the relationship of significant biochemical parameters with hemodynamic parameters and primary endpoints.Materials and methods. We observed 104 male patients of working age who were admitted to the hospital with primary Q-MI, receiving rosuvastatin at a dose of 40 mg and atorvastatin at a dose of 80 mg as part of complex therapy. Results. A direct correlation was found between the baseline parameters of C-reactive protein (CRP), aldosterone, creatinine phosphokinase, erythrocyte sedimentation rate, leukocytes, left ventricular myocardial mass (LVMM) and the primary endpoints studied during 12 months of observation in patients of working age who underwent Q-myocardial infarction. Conclusions. Thus, the baseline level of CRP, aldosterone, creatinine phosphokinase, erythrocyte sedimentation rate, blood leukocytes and LVMM were the prognostic markers of the severity of postinfarction course in patients of working age who underwent Q-MI.

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P842Calculated plasma volume status provides additional prognostic value to global registry of acute coronary event (GRACE) score in patients with acute myocardial infarction

European Heart Journal ◽

10.1093/eurheartj/ehz747.0440 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Kawai ◽

D Nakatani ◽

T Yamada ◽

T Morita ◽

Y Furukawa ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Body Weight ◽

Plasma Volume ◽

Prognostic Value ◽

Coronary Event ◽

Volume Status ◽

Acute Coronary Event ◽

Global Registry ◽

Grace Score

Abstract Background Plasma volume status (PVS) has been shown to be a well-validated prognostic indicator which relate to morbidity and mortality in heart failure. However, it remains unclear whether PVS would have the prognostic significance in patients with acute myocardial infarction (AMI). Global Registry of Acute Coronary Events (GRACE) risk score is a powerful predictor of prognosis after acute coronary event, but there is no information available on the additional prognostic value of PVS to GRACE in AMI patients. Methods We retrospectively studied 3930 AMI patients. GRACE score and PVS was obtained on the admission. PVS was calculated as follows: actual PV = (1 - hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females); and PVS = [(actual PV - ideal PV)/ideal PV] × 100 (%). The endpoint was All cause of death (ACD) within 5 years. Results During a mean follow-up period of 2.4±1.9 years, 406 patients had ACD. PVS was significantly greater in patients with ACD than without ACD (8.1±14.9% vs −1.7±13.3%, p<0.001). Each 5% increase in PVS was linked to a 27% estimated risk of 5-year mortality (p<0.001, HR: 1.05 [1.03–1.08]). PVS was still independently associated with ACD, after adjustment with GRACE score as a potential confounding factor. Kaplan-Meier analysis revealed that patients with PV expansion (PVS>0%) were significantly higher risk of ACD than those without PV expansion in patients both with high risk in GRACE score (>140) (28% (225/803) vs 19% (78/412), p=0.01, HR: 7.5) and with low risk in GRACE score (≤140) (6% (52/894) vs 3% (51/1821), p=0.009, HR: 6.2). Survival rate curves Conclusion PVS, which represents intravascular compartment and congestion, could identify poor prognosis in patients with AMI. In addition, PVS would provide additional prognostic information to GRACE score.

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Validation of different score systems in predicting cardiac arrest occurrence of ST-elevation myocardial infarction

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907917724729 ◽

2017 ◽

Vol 24 (5) ◽

pp. 224-229

Author(s):

Ko-Wen Han ◽

Shou-Yen Chen ◽

Yi-Ming Weng ◽

Chip-Jin Ng ◽

Te-Fa Chiu ◽

...

Keyword(s):

Myocardial Infarction ◽

Emergency Department ◽

Cardiac Arrest ◽

Risk Score ◽

Coronary Event ◽

St Elevation Myocardial Infarction ◽

Acute Coronary Event ◽

Event Risk ◽

St Elevation ◽

Global Registry

Introduction: Patients with ST-elevation myocardial infarction are at risk of developing cardiac arrest. A validated tool for predicting cardiac arrest would help physicians recognize these high-risk patients earlier. This study assessed the usefulness of various score systems in predicting cardiac arrest in patients hospitalized for ST-elevation myocardial infarction. Methods: Patients’ data were retrieved from the hospital’s ST-elevation myocardial infarction registry records. Patients aged 18 years or older seen at the emergency department with a diagnosis of ST-elevation myocardial infarction between 1 July 2013 and 30 June 2014 were enrolled. The Thrombolysis in Myocardial Infarction score, the 6-month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART score were calculated and compared. Results: A total of 249 patients were recruited. The Thrombolysis in Myocardial Infarction score, 6-month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART scores were calculated. In total, 41 (16.5%) patients had cardiac arrest at emergency department or during hospitalization and 12 (29.3%) of them survived. The 6-month Global Registry of Acute Coronary Event risk score had the biggest area under the receiver-operating characteristic curve (0.72). Conclusion: The 6-month Global Registry of Acute Coronary Event risk score is more useful in predicting cardiac arrest in patients hospitalized for ST-elevation myocardial infarction than the other three scores. It is recommended that the 6-month Global Registry of Acute Coronary Event risk score be calculated for identifying emergency department patients hospitalized for ST-elevation myocardial infarction who are at risk of cardiac arrest during their hospital stay.

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