### Description

The risk of mortality 1 year after an acute myocardial infarction with or without treatment with a thrombolytic agent can be estimated using a predictive instrument developed by Selker et al..

Parameters:

(1) age in years

(2) heart rate

(3) ST wave changes of anterior myocardial infarction

(4) abnormal Q waves

(5) right bundle branch block

 Parameter Finding Value patient age < 60 years 60 60 to < 75 years 75 >= 75 years age heart rate < 70 beats per minute 0 70 to < 120 beats per minute (heart rate) - 70 >= 120 beats per minute 50 anterior myocardial infarction 2 - 4 contiguous leads in V1, V2, V3, V4 with ST wave elevations 1 0 or 1 contiguous leads in V1, V2, V3, V4 with ST wave elevations 0 number of contiguous Q waves 0 or 1 contiguous leads with abnormal Q waves 0 2 - 4 contiguous leads with abnormal Q waves (number of contiguous leads with abnormal Q waves) - 1 > 4 contiguous leads with abnormal Q waves 3 right bundle branch block present 1 absent 0

where:

• While the age given above is as listed in the paper, other age-related tables in the paper would have used the patient's age for 60 to < 75 and 75 if the age was >= 75.

• In contiguous leads with ST-wave elevations there must be at least 1 lead with an elevation >= 1 mm and 1 lead with an elevation >= 0.5 mm

• If more than 4 contiguous leads have abnormal Q waves, the number of contiguous leads is set to 4. This is equivalent to MIN(4, leads with Q waves).

score =

= (0.1085 * (value for age)) + (0.0371 * (value for heart rate)) + (0.1464 * (value for number of leads with contiguous Q waves)) + (0.5855 * (value for anterior acute MI)) + (1.2458 * (value for right bundle branch block)) - 11.1084

risk of mortality after 30 days =

= 1 / (1 + EXP((-1) * (score)))

risk of 1 year mortality =

= (risk of 30 day mortality) + ((1 - (risk of 30 day mortality)) * (risk of mortality after 30 days))

where:

• The risk of 30 day mortality may be with or without thrombolytic agent therapy.