Boersma et al evaluated patients with an acute coronary event (unstable angina or acute myocardial infarction) without persistent ST segment elevation. They developed a risk model that can help identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in North America and Europe participating in the PURSUIT trial.
Parameters:
(1) age in years
(2) gender
(3) worst Canadian Cardiovascular Society class in past 6 weeks
(4) signs of heart failure (rales, etc)
(5) ST depression on presenting ECG
(6) heart rate in beats per minute
(7) systolic blood pressure in mm Hg
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
1 |
|
worst Canadian Cardiovascular Society class |
0, I or II |
0 |
|
|
III or IV |
2 |
|
signs of heart failure |
no |
0 |
|
|
yes |
3 |
|
ST segment depression |
no |
0 |
|
|
yes |
3 |
|
systolic blood pressure |
120 mm Hg |
0 |
|
|
100 mm Hg |
1 |
|
|
80 mm Hg |
2 |
|
Age |
Points with Unstable Angina |
Points with AMI |
|
50 |
0 |
0 |
|
60 |
2 |
3 |
|
70 |
4 |
6 |
|
80 |
6 |
9 |
|
Heart Rate |
Points with Unstable Angina |
Points with AMI |
|
80 |
0 |
0 |
|
100 |
1 |
2 |
|
120 |
2 |
5 |
where:
• The point assignment is probably inaccurate for a systolic blood pressure or heart rate that differs from the values given.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 25 points
• The higher the score the greater the risk of 30 mortality.
|
Risk Score |
Risk |
|
< 4 |
< 1% |
|
>= 4 |
((0.001894 * ((score)^3)) + (0.0416 * ((score)^2)) - (0.4247 * (score)) + 2.006) / 100*100% |
Specialty: Cardiology
ICD-10: ,
