Developing and Validating a Simple Risk Score for Patients with Acute Myocardial Infarction
Zheng-Yang Ge1, Yang He2, Ting-Bo Jiang1
1Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Insights
A new risk score, BACEF (serum alBumin, Age, serum Creatinine, and LVEF), accurately predicts 4-year mortality in acute myocardial infarction (AMI) patients. This simple tool offers improved risk stratification for AMI survivors.
Area of Science:
- Cardiology
- Clinical Risk Stratification
- Biostatistics
Background:
- Mortality from acute myocardial infarction (AMI) remains a significant clinical challenge.
- Effective risk stratification is crucial for managing AMI patients post-intervention.
Purpose of the Study:
- To develop and validate a novel, simple risk score for predicting 4-year all-cause mortality in patients with AMI.
- To assess the performance of the new score against existing risk stratification tools.
Main Methods:
- Utilized data from the CatLet validation trial and its extension for derivation and validation.
- Employed Lasso regression analysis for covariate selection and coefficient estimation.
- The endpoint was 4-year all-cause mortality in patients undergoing percutaneous intervention (PCI).
Main Results:
- Developed the BACEF score, incorporating serum albumin, age, serum creatinine, and LVEF.
- Achieved strong predictive performance with AUCs ranging from 0.83 to 0.89 across validation sets.
- The BACEF score demonstrated superior performance compared to ACEF, ACEF II, and GRACE scores for 4-year mortality prediction.
Conclusions:
- The novel BACEF score is a simple, validated, and well-calibrated tool for risk stratification in AMI patients.
- This score has the potential to be a valuable instrument for clinicians in managing long-term outcomes for AMI survivors.
Introduction:
Mortality from acute myocardial infarction (AMI) remains substantial. The current study is aimed at developing a novel simple risk score for AMI.
Methods:
The Coronary Artery Tree description and Lesion EvaluaTion (CatLet) extended validation trial (ChiCTR2000033730) and the CatLet validation trial (ChiCTR-POC-17013536), both being registered with
Results:
Of 26 candidate predictor variables, the four strongest predictors for 4-year mortality were included in this novel risk score with an acronym of BACEF (serum alBumin, Age, serum Creatinine, and LVEF). This score was well calibrated and yielded an AUC (95% CI) statistics of 0.84 (0.80-0.87) in internal validation, 0.89 (0.83-0.95) in internal-external (temporal) validation, and 0.83 (0.77-0.89) in external validation. Notably, it outperformed the ACEF, ACEF II, GRACE scores with respect to 4-year mortality prediction.
Conclusion:
A simple risk score for 4-year mortality risk stratification was developed, extensively validated, and calibrated in patients with AMI. This novel BACEF score may be a useful risk stratification tool for patients with AMI.
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