Accuracy of Dedicated Risk Scores in Patients Undergoing Primary Percutaneous Coronary Intervention in Daily Clinical Practice

Abelin, Aníbal P.; David, Renato Budzyn; Gottschall, Carlos Antônio Mascia; Quadros, Alexandre Schaan de

doi:10.1016/j.cjca.2013.07.673

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…The TIMI risk score was first developed for fibrinolytic-eligible patients with STEMI, and its accuracy and clinical applicability were validated in patients with STEMI undergoing PCI ( 16 , 17 ). This score is recommended by contemporary guidelines for use in patients with STEMI, and is a simple bedside scoring tool that can effectively predict in-hospital mortality ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Shock Index-C: An Updated and Simple Risk-Stratifying Tool in ST-Segment Elevation Myocardial Infarction

Ran

Wei

Lin

et al. 2021

Front. Cardiovasc. Med.

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Background: Shock index (heart rate/systolic blood pressure, SI) is a simple scale with prognostic value in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). The present study introduces an updated version of SI that includes renal function.Methods: A total of 1,851 consecutive patients with STEMI undergoing PCI were retrospectively included at Cardiac Care Unit in Guangdong Provincial People's Hospital and divided into two groups according to their admission time: derivation database (from January 2010 to December 2013, n = 1,145) and validation database (from January 2014 to April 2016, n = 706). Shock Index-C (SIC) was calculated as (SI × 100)–estimated CCr. Calibration was evaluated using the Hosmer-Lemeshow statistic. The predictive power of SIC was evaluated using receiver operating characteristic (ROC) curve analysis.Results: The predictive value and calibration of SIC for in-hospital death was excellent in derivation [area under the curve (AUC) = 0.877, p < 0.001; Hosmer-Lemeshow chi-square = 3.95, p = 0.861] and validation cohort (AUC = 0.868, p < 0.001; Hosmer-Lemeshow chi-square = 5.01, p = 0.756). SIC exhibited better predictive power for in-hospital events than SI (AUC: 0.874 vs. 0.759 for death; 0.837 vs. 0.651 for major adverse clinical events [MACEs]; 0.707 vs. 0.577 for contrast-induced acute kidney injury [CI-AKI]; and 0.732 vs. 0.590 for bleeding, all p < 0.001). Cumulative 1-year mortality was significantly higher in the upper SIC tertile (log-rank = 131.89, p < 0.001).Conclusion: SIC was an effective predictor of poor prognosis and may have potential as a novel and simple risk stratification tool for patients with STEMI undergoing PCI.

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Section: Discussionmentioning

confidence: 99%

Shock Index-C: An Updated and Simple Risk-Stratifying Tool in ST-Segment Elevation Myocardial Infarction

Ran

Wei

Lin

et al. 2021

Front. Cardiovasc. Med.

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“…Although the ischemic risk may accrue progressively following the acute event [24], the predictive value of clinical risk scores diminishes over time [25]. There are also problems with clinical risk scores related to limited use [26], differences in their predictive value [27,28] and poor performance in patients with STEMI after PPCI [28,29]. All but one [8] of the existing risk scores have been developed in pre high-sensitivity troponin era.…”

Section: Discussionmentioning

confidence: 99%

High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction

Ndrepepa

Kufner

Hoyos

et al. 2018

Journal of Cardiology

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“…Tirofiban was used before PCI in patients with a high TIMI risk score by the primary operator’s discretion (12). Since there was no recommendation of a standard dose of tirofiban for STEMI at the time of the study, tirofiban was used in doses established for PCI patients.…”

Section: Methodsmentioning

confidence: 99%

The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI

Kaymaz¹,

Keleş²,

Özdemir³

et al. 2015

Anatol J Cardiol

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Objective:The present study was designed to determine the effects of tirofiban (Tiro) infusion on angiographic measures, ST-segment resolution, and clinical outcomes in patients with STEMI undergoing PCI. Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), while the most effective timing of administration is still under investigation.Methods:A total of 1242 patients (83.0% males, mean (standard deviation; SD) age: 54.7 (10.9) years) with STEMI who underwent primary PCI were included in this retrospective non-randomized study in four groups, composed of no tirofiban infusion [Tiro (-); n=248], tirofiban infusion before PCI (pre-Tiro; n=720), tirofiban infusion during PCI (peri-Tiro; n=50), and tirofiban infusion after PCI (post-Tiro; n=224). In all Tiro (+) patients, bolus administration of Tiro (10 pg/kg) was followed by infusion (0.15 pg/kg/min) for a mean (SD) duration of 22.4±6.8 hours.Results:The pre-PCI Tiro group was associated with the highest percentage of patients with TIMI 3 flow (99.4%; p<0.001), the lowest corrected TIMI frame count [21(18-23.4); p<0.001], the highest percentage of patients with >75% ST-segment resolution (78.1%; p<0.001), and the lowest rate of in-hospital sudden cardiac death and in-hospital all-cause mortality (3.2%, p<0.05, 3.3%, p=0.01). Major bleeding was reported in 18 (1.8%) patients who received tirofiban.Conclusion:Use of standard-dose bolus tirofiban in addition to aspirin, high-dose clopidogrel, and unfractionated heparin prior to primary PCI significantly improves myocardial reperfusion, ST-segment resolution, in-hospital mortality rate, and in-hospital sudden cardiac death in patients with STEMI with no increased risk of major bleeding.

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Accuracy of Dedicated Risk Scores in Patients Undergoing Primary Percutaneous Coronary Intervention in Daily Clinical Practice

Cited by 11 publications

References 29 publications

Shock Index-C: An Updated and Simple Risk-Stratifying Tool in ST-Segment Elevation Myocardial Infarction

Shock Index-C: An Updated and Simple Risk-Stratifying Tool in ST-Segment Elevation Myocardial Infarction

High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction

The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI

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