Prognostic Value of the Age, Creatinine, and Ejection Fraction Score for 1-Year Mortality in 30-Day Survivors Who Underwent Percutaneous Coronary Intervention After Acute Myocardial Infarction
- Author(s)
- Jang Hoon Lee; Myung Hwan Bae; Dong Heon Yang; Hun Sik Park; Yongkeun Cho; Myung Ho Jeong; Young Jo Kim; Kee-Sik Kim; Seung Ho Hur; In Whan Seong; Myeong Chan Cho; Chong Jin Kim; Shung Chull Chae
- Keimyung Author(s)
- Hur, Seung Ho
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- American Journal of Cardiology
- Issued Date
- 2015
- Volume
- 115
- Issue
- 9
- Abstract
- Few simple and effective tools are available for determining the prognosis of 30-day
survivors after acute myocardial infarction. We aimed to assess whether the simple age,
creatinine, and ejection fraction (ACEF) score could predict 1-year mortality of 12,000 poste
myocardial infarction 30-day survivors who underwent percutaneous coronary intervention.
The ACEF score was computed as follows: (age/ejection fraction) D 1, if the serum
creatinine was >2 mg/dl. Accuracy was defined through receiver-operating characteristics
analysis and area under the curve (AUC) evaluation. Twelve risk factors were selected
and ranked according to their AUC value. Age, ejection fraction, and serum creatinine
levels indicated the best AUC value. The ACEF score was significantly higher in the nonsurvivors
(1.95 – 0.82 vs 1.28 – 0.50; p <0.001) and was an independent predictor of 1-year
mortality (adjusted hazard ratio 2.26; p <0.001). The best accuracy was achieved by a
prediction model including 12 risk factors (AUC[ 0.80), but this did not significantly differ
compared with the AUC (0.79) of the ACEF score (p [ ns). Adjusted hazard ratios for
1-year mortality were 1 (reference), 3.11 (p <0.001), and 10.38 (p <0.001) for the ACEFLOW
(ACEF score <1.0), ACEFMID (ACEF score 1.0 to 1.39), and ACEFHIGH (ACEF score ‡1.4)
groups, respectively. The ACEF score may be a novel valid model to stratify the 1-year
mortality risk in 30-day survivors who underwent percutaneous coronary intervention
after acute myocardial infarction. 2015 Elsevier Inc. All rights reserved. (Am J Cardiol
2015;115:1167e1173)
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