ACEF score adapted to ST-elevation myocardial infarction patients: The ACEF-STEMI score

摘要: Abstract Background The age, creatinine and ejection fraction (ACEF) score has originally been developed for risk stratification of patients undergoing elective cardiac surgery. In with stable coronary artery disease treated by percutaneous intervention (PCI), the prognostic accuracy ACEF could be further improved modifying original scoring system (called "modified ACEF" or "ACEF-MDRD"). We aimed to specifically adapt assessment ST-elevation myocardial infarction (STEMI) patients. Methods this observational study, 390 STEMI primary PCI were included. Clinical endpoint was occurrence major adverse cardiovascular events (MACE) comprising all-cause mortality, non-fatal re-infarction, stroke new congestive heart failure. Results Original (area under curve (AUC):0.63 [95%CI:0.53–0.73]; p  = 0.01) ACEF-MDRD (AUC:0.62 [95%CI:0.53–0.72]; significantly but weakly predicted MACE ( n  = 41, 11%). addition creatinine > 2 mg/dl (as suggested in ACEF,  = 0.32) eGFR steps as proposed  = 0.17) age/EF ratio not associated net reclassification improvements (NRI), ΔeGRF (>10 ml/min/1.73 m 2 decrease within three days after PCI) led an NRI 0.29 (95%CI:0.14–0.45;  = 0.03). Conclusions PCI, novel ACEF-STEMI provided strong value superior discriminative ability compared previously described scores.