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Relationship of the ORBIT and HAS-BLED scores with Killip class 3-4 in patients with ST-segment elevation myocardial

Qing Zhang1, Lei Zhou2, Hong-Li Cai1

  • 1Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong.

Medicine
|March 1, 2019
PubMed

Insights

The Outcomes Registry for Better Informed Treatment (ORBIT) and HAS-BLED scores predict heart failure complications in ST-segment elevation myocardial infarction (STEMI) patients. Higher scores indicate an increased risk of severe heart failure (Killip class 3-4).

Area of Science:

  • Cardiology
  • Clinical Research
  • Medical Scoring Systems

Background:

  • Heart failure (HF) is a serious complication of ST-segment elevation myocardial infarction (STEMI).
  • Assessing bleeding risk in anticoagulated atrial fibrillation patients uses HAS-BLED and Outcomes Registry for Better Informed Treatment (ORBIT) scores.
  • The predictive value of these scores for severe HF (Killip class 3-4) in STEMI patients requires investigation.

Purpose of the Study:

  • To investigate the relationship between ORBIT and HAS-BLED scores and Killip class 3-4 in STEMI patients.
  • To assess the predictive value of ORBIT and HAS-BLED scores for severe heart failure post-STEMI.

Main Methods:

  • 639 STEMI patients were enrolled, with ORBIT and HAS-BLED scores recorded upon admission.
  • Patients were categorized into Killip class 1-2 and Killip class 3-4 groups for comparison.
  • Receiver-operating characteristic (ROC) analyses and logistic regression were used to evaluate score predictiveness.

Main Results:

  • ORBIT and HAS-BLED scores were significantly higher in the Killip class 3-4 group compared to the Killip class 1-2 group.
  • ROC analysis showed areas under the curve of 0.818 for ORBIT and 0.674 for HAS-BLED in predicting Killip class 3-4.
  • Multivariate analysis confirmed that a high ORBIT score was independently associated with Killip classes 3-4 (OR: 2.306).

Conclusions:

  • A graded relationship exists between elevated ORBIT and HAS-BLED scores and the occurrence of Killip classes 3-4 in STEMI patients.
  • The ORBIT score demonstrates independent predictive value for severe heart failure (Killip 3-4) in the context of STEMI.

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