Addala et al reported a risk score for mortality in patients with an ST-segment elevation acute myocardial infarction undergoing a percutaneous coronary intervention. This can help identify patients who may benefit from more aggressive management. The authors participated in the PAMI trial (Primary Angioplasty in Myocardial Infarction)
Parameters:
(1) age in years
(2) Killip class
(3) heart rate in beats per minute
(4) diabetes mellitus
(5) anterior myocardial infarction (anterior MI)
(6) left bundle branch block (LBBB)
|
Parameter |
Finding |
Points |
|
age in years |
< 65 years |
0 |
|
|
65 to 75 years |
3 |
|
|
>= 76 years |
7 |
|
Killip class |
I |
0 |
|
|
II, III or IV |
2 |
|
heart rate |
<= 100 beats per minute |
0 |
|
|
> 100 beats per minute |
2 |
|
diabetes mellitus |
absent |
0 |
|
|
present |
2 |
|
anterior MI or LBBB |
either present |
2 |
|
|
neither present |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the greater the risk of mortality within 6 months.
|
Total Score |
Risk of 6 Month Mortality (All Patients) |
Risk of 6 Month Mortality (in Hospital Survivors) |
|
0 or 1 |
< 1% |
< 1% |
|
2 to 4 |
3% |
1.5% |
|
5 to 8 |
6% |
2% |
|
9 to 15 |
20% |
8% |
where:
• In Figure 4 the 6 month mortality for a score of 7 to 8 was 15% in the AIR-PAMI and local Med trials.
Specialty: Cardiology
ICD-10: ,
