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Updated: Jan 22, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Bedside prediction of 9-year mortality after ST‑segment elevation myocardial infarction treated with primary
Magdalena Polańska-Skrzypczyk1, Maciej Karcz1, Witold Rużyłło2
1Institute of Cardiology, Department of Interventional Cardiology and Angiology, Warsaw, Poland
Insights
A new 4-variable risk score accurately predicts 9-year mortality in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (pPCI). This simple bedside tool stratifies risk, identifying low-risk patients with excellent prognoses.
Area of Science:
- Cardiology
- Clinical Risk Stratification
- Myocardial Infarction Research
Background:
- Prognosis after ST-segment elevation myocardial infarction (STEMI) is variable despite similar treatments.
- Accurate long-term mortality risk stratification is needed for targeted interventions.
Purpose of the Study:
- To develop and validate a simple risk score for 9-year all-cause and cardiovascular mortality in STEMI patients.
- To utilize routinely collected data for risk prediction after primary percutaneous coronary intervention (pPCI).
Main Methods:
- Patients with STEMI undergoing pPCI were divided into building and validating groups.
- Logistic regression models were used to develop the ANIN risk scores (I for all-cause, II for cardiovascular mortality).
- Risk factors were identified and validated in the second cohort.
Main Results:
- A 4-variable risk score (ANIN risk score I) demonstrated high predictive accuracy.
- Key predictors identified were age, renal dysfunction, Killip class, and thrombolysis in myocardial infarction flow.
- Identified risk subgroups showed distinct 9-year mortality rates: 10% (low), 37% (intermediate), and 71% (high).
Conclusions:
- A simple 4-variable bedside risk score accurately predicts long-term mortality post-STEMI treated with pPCI.
- The score is readily calculable immediately after pPCI.
- Low-risk patients identified by this score have a favorable long-term prognosis.
Background:
Despite similar underlying pathogenesis, clinical features, and management of ST‑segment elevation myocardial infarction (STEMI), the long‑term prognosis of patients is highly variable. The ability to stratify an individual's long‑term mortality risk could facilitate development of focused interventions aimed at reducing poor long‑term outcomes.
Aims:
This study aimed to develop and validate a simple risk score based on routinely collected data for all‑cause and cardiovascular 9-year mortality in a homogeneous group of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).
Methods:
All consecutive patients with STEMI treated with pPCI were randomly divided into 2 groups. The first group was called the building group and was used to develop logistic regression models that were converted into a simple risk scores that estimated all‑cause and cardiovascular long‑term mortality risk (ANIN risk score I and II, respectively) and subsequently validated in the second group, called the validating group.
Results:
The 9-year follow‑up data were available in 1059 out of 1064 patients with STEMI. We developed 4 independent risk scores with the highest predictive accuracy of ANIN risk score I. Validation cohorts identified 4 most important risk factors: age, renal dysfunction, Killip class, and thrombolysis in myocardial infarction flow. Low, intermediate, and high‑risk subgroups were identified based on those factors with different long‑term mortalities: 10%, 37%, and 71%, respectively.
Conclusions:
Long‑term mortality after STEMI treated with pPCI can be accurately predicted using 4-variable bedside risk score, which is ready to calculate right after pPCI. Patients in the low‑risk group have an excellent prognosis despite having experienced potentially lethal disease.
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