Risk Score of Chen et al for Identifying Silent Myocardial Ischemia in a Patient with Coronary Artery Disease, Aspirin Therapy and Upper Gastrointestinal Hemorrhage

Description

Chen et al developed a score for predicting silent myocardial ischemia in a patient with coronary artery disease, aspirin therapy and upper gastrointestinal bleeding. A patient at risk for myocardial ischemia may benefit from more aggressive management. The authors are from Shin-Kong Wu Ho-Su Memorial Hospital, Fu Jen Catholic University, National Yang-Ming University, Veterans General Hospital and Taipei Medical University in Taiwan.

Patient selection: coronary artery disease with aspirin therapy, upper gastrointestinal hemorrhage

Parameters:

(1) age in years

(2) systolic blood pressure

(3) diastolic blood pressure

(4) hematocrit

(5) BUN to creatinine ratio

(6) number of coronary arteries with significant arteriosclerosis

BUN to creatinine ratio =

= (serum BUN in mg/dL) / (serum creatinine in mg/dL)

Parameter	Finding	Points
age in years	<= 75 years of age	0
	> 75 years of age	1
systolic blood pressure	>= 110 mm Hg	0
	< 110 mm Hg	1
diastolic blood pressure	>= 85 mm Hg	0
	< 85 mm Hg	2
hematocrit	>= 30%	0
	< 30%	1
BUN to creatinine ratio	<= 30	0
	> 30	1
number of coronary arteries	1 (single, SVD)	0
	2 (double vessel, DVD)	1
	3 (triple vessel, TVD)	2

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 8

• The higher the score the greater the risk for silent myocardial ischemia.

• A score >= 5 indicates high risk for myocardial ischemia.

Performance:

• The area under the ROC curve was 0.93.

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Description

Specialty

ICD-10