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Revista argentina de cardiología
versión On-line ISSN 1850-3748
Resumen
BURGOS, LUCRECIA M. et al. Validation and Comparison of Two Risk Stratification Models in ST-Segment Elevation Myocardial Infarction. Rev. argent. cardiol. [online]. 2019, vol.87, n.2, pp.118-124. Epub 01-Mar-2019. ISSN 1850-3748. http://dx.doi.org/10.7775/rac.es.v87.i2.13339.
Background:
Risk scores are recommended to stratify and predict mortality in ST-segment elevation acute myocardial infarction (STEMI). The ProACS and Simple Risk Index (SRI) models are simple scores that have demonstrated adequate predictive capacity of in-hospital mortality in other countries.
Objective:
The aim of this study was to validate and compare the ProACS and SRI scores as predictors of in-hospital mortality in patients with STEMI.
Methods:
This was a retrospective analysis of a cohort composed of consecutive patients from the CONAREC XVII registry hospitalized with STEMI diagnosis. The predictive value for in-hospital mortality was estimated and validity was assessed by discrimination and calibration.
Results:
The study analyzed 694 patients. In-hospital mortality was 8.78%. The median ProACS score was 4 (IQR 25-75, 2.5-5) in patients who presented the event, and 2 (IQR 25-75 1-3) in those without the event (p<0.001) and the median SRI score was 41.3 (IQR 25-75, 29.8-62.5) and 20.8 (IQR 25-75 15.4-30) in those who died and those who did not, respectively (p<0.001). The SRI score showed excellent discrimination (AUC 0.83, 95% CI 0.78-0.88, p=0.001) and the ProACS score evidenced good discrimination (AUC 0.78, 95% CI 0.71-0.86, p= 0.001) for the outcome. The HL test applied to the ProACS score presented χ2=8.6 (p=0.3), and the SRI score χ2=5.4 (p=0.7).
Conclusions:
The ProACS and SRI risk scores for the prediction of in-hospital mortality were adequately validated in patients with STEMI in Argentina. This suggests their suitability for clinical use in this population.
Palabras clave : Myocardial infarction; ST elevation myocardial infarction; Acute coronary síndrome; Prognosis.