Validation and Comparison of Six Risk Scores for Infection in Patients With ST-Segment Elevation Myocardial...

Area of Science:

• Cardiology
• Infectious Disease Prediction
• Medical Informatics

Background:

• Predicting infection risk in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) is crucial for patient outcomes.
• Existing risk scores for infection prediction in this population have limited validation and comparative data.

Purpose of the Study:

• To validate and compare the discriminatory performance of six established risk scores for predicting infection in STEMI patients undergoing PCI.
• To assess the calibration and discrimination of these scores for in-hospital major adverse clinical events (MACE).

Main Methods:

• A cohort of 2,260 STEMI patients undergoing PCI between January 2010 and May 2018 was analyzed.
• Six risk scores were evaluated: ACEF/AGEF, CACS, CHADS2, GRACE, and Mehran.
• Primary endpoint was in-hospital infection; secondary endpoint was in-hospital MACE.

Main Results:

• ACEF, AGEF, CACS, GRACE, and Mehran scores demonstrated good discrimination for predicting infection, unlike the CHADS2 score.
• Most scores, except CACS, showed good calibration for infection prediction.
• All scores, except CHADS2, showed good discrimination for MACE, and all exhibited excellent calibration for MACE.

Conclusions:

• The ACEF, AGEF, CACS, GRACE, and Mehran risk scores are valuable tools for predicting both infection and MACE in STEMI patients post-PCI.
• These validated scores can aid in risk stratification and clinical decision-making for this patient group.