Prognostic Impact of Prehospital Simple Risk Index in Patients With ST-Elevation Myocardial Infarction.

Area of Science:

• Cardiology
• Emergency Medicine
• Clinical Risk Stratification

Background:

• The emergency room simple risk index (ER-SRI) stratifies prognosis in ST-elevation myocardial infarction (STEMI) patients.
• The prognostic value of the prehospital simple risk index (Pre-SRI) in STEMI patients was previously unknown.

Purpose of the Study:

• To evaluate the prognostic impact of the prehospital simple risk index (Pre-SRI) in STEMI patients.
• To compare the accuracy of Pre-SRI and ER-SRI in predicting 30-day mortality.
• To assess the incremental prognostic value of combining Pre-SRI and ER-SRI.

Main Methods:

• 2,047 STEMI patients from the Mie Acute Coronary Syndrome (ACS) registry were analyzed.
• Pre-SRI and ER-SRI were calculated using prehospital and emergency room data, respectively.
• Receiver operating characteristic (ROC) analysis and multivariate Cox regression were used to assess predictive accuracy and independent predictors of 30-day mortality.

Main Results:

• Both Pre-SRI (cut-off 34.8) and ER-SRI (cut-off 34.1) accurately predicted 30-day mortality (accuracy 0.816 and 0.826, respectively).
• High Pre-SRI (≥34) was a significant independent predictor of 30-day mortality.
• Combining High Pre-SRI and High ER-SRI identified patients with significantly higher mortality, indicating incremental prognostic value.

Conclusions:

• Pre-SRI is a valuable tool for early identification of high-risk STEMI patients.
• Combined assessment of Pre-SRI and ER-SRI enhances risk stratification accuracy for STEMI patients.