Peterson et al developed a risk score for patients with the acute coronary syndrome (ACS). The authoers are PURSUIT (Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy) investigators and from the Cleveland Clinic.
Patient selection: age 50 to 89, unstable angina or acute myocardial infarction (AMI)
Parameters:
(1) age decade and enrollment diagnosis
(2) gender
(3) worst Canadian Cardiovascular Society (CCS) class for angina in previous 6 weeks
(4) signs of heart failure
(5) ST segment depression on presenting ECG
Parameter
Finding
Points
age decade and diagnosis
50 and unstable angina
8
60 and unstable angina
9
70 and unstable angina
11
80 and unstable angina
12
50 and AMI
11
60 and AMI
12
70 and AMI
13
80 and AMI
14
gender
male
1
female
0
worst CCS class
none
0
CCS I or II
0
CCS III or IV
2
signs of heart failure
no
0
yes
2
ST-segment depression
no
0
yes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 8
• maximum score: 20
• The higher the score the worse the prognosis.
Score
30 day AMI or death
1 year AMI or death
8 or 9
6.5%
9.7%
10 to 12
3.6%
10.1%
13 or 14
5.5%
14.1%
15 to 20
12.9%
25%
from Figure 6, Conti et al
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