A New Risk Model for Stemi Treated With Primary Pci: The Alpha Score

Hizoh, István; Gulyás, Zalán; Szabó, Gábor; Majoros, Zsuzsanna; Major, László; Kerecsen, Gábor; Kiss, Róbert Gábor

doi:10.1016/s0735-1097(13)60099-6

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“…The total mortality rate in TACSR was 17% and primary PCI was performed in 22.24% of all patients. Recently, the ALPHA score defined five variables (age, heart rate, systolic blood pressure, access site, and anterior localisation of the infarction) that were associated with 30-day mortality in patients with STEMI treated with primary PCI 31. The ALPHA score could be calculated without the need for ventriculography and blood tests.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of in-hospital mortality in all comers with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention

2016

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BackgroundThe prognostic factors of in-hospital mortality in all comers and unselected patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) have not been well established. Objective To identify the predictive factors of inhospital mortality in patients with STEMI undergoing primary PCI in a tertiary heart centre. Methods Between January 2008 and December 2011, all patients with STEMI undergoing primary PCI were retrospectively included in this study. Baseline characteristics and angiographic data were reviewed and recorded. The study endpoint was all-cause in-hospital mortality.Results Of the 541 patients included in the study, 63 (11.6%) died during hospitalisation. Cardiogenic shock at admission was recorded in 301 patients (55.6%) and 424 patients (78%) had multivessel disease. Median door-to-device time was 65 min. After adjustment for baseline variables, the factors associated with in-hospital mortality included age >60 years (OR 2.98, 95% CI 1.17 to 7.05; p=0.01), left ventricular ejection fraction <40% (OR 2.53, 95% CI 1.20 to 5.36; p=0.02), and final TIMI flow grade 0/1 (OR 20.55, 95% CI 3.49 to 120.94; p=0.001). Conclusions Age, left ventricular function and final TIMI flow are significant predictors of adverse outcomes in unselected patients with STEMI undergoing primary PCI.

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Section: Discussionmentioning

confidence: 99%