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 (CCS) class in past 6 weeks
(4) signs of heart failure (rales, etc)
(5) ST depression on presenting ECG
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
2
ST segment depression
no
0
yes
1
Age
Points with Unstable Angina
Points with AMI
50
8
11
60
9
12
70
11
13
80
12
14
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20 points
• The higher the score the greater the risk of 30 mortality or non-fatal reinfarction.
