Development of an optimized risk score to predict short-term death among acute myocardial infarction patients in rural China.

BACKGROUND

Risk stratification of patients with acute myocardial infarction (AMI) is of great clinical significance.

HYPOTHESIS

The present study aimed to establish an optimized risk score to predict short-term (6-month) death among rural AMI patients from China.

METHODS

We enrolled 6581 AMI patients and extracted relevant data. Patients were divided chronologically into a derivation cohort (n = 5539), to establish the multivariable risk prediction model, and a validation cohort (n = 1042), to validate the risk score.

RESULTS

Six variables were identified as independent predictors of short-term death and were used to establish the risk score: age, Killip class, blood glucose, creatinine, pulmonary artery systolic pressure, and percutaneous coronary intervention treatment. The area under the ROC curve (AUC) of the optimized risk score was 0.82 within the derivation cohort and 0.81 within the validation cohort. The diagnostic performance of the optimized risk score was superior to that of the GRACE risk score (AUC 0.76 and 0.75 in the derivation and validation cohorts, respectively; p < .05).

CONCLUSION

These results indicate that the optimized scoring method developed here is a simple and valuable instrument to accurately predict the risk of short-term mortality in rural patients with AMI.