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Korean J Med > Volume 88(2); 2015 > Article
The Korean Journal of Medicine 2015;88(2): 168-176.
급성 ST분절 비상승 환자의 1년 사망률 예측을 위한 새로운 위험 도구
박진희1,3, 박인혜2, 정명호1,4, 이숙자1,3, 장수영1,4, 조재영1,4, 정해창1,4, 이기홍1,4, 박근호1,4, 심두선1,4, 김계훈1,4, 홍영준1,4, 박형욱1,4, 김주한1,4, 안영근1,4, 조정관1,4, 박종춘1,4
1전남대학교병원 심장센터
2전남대학교 간호대학
3전남대학교병원 간호부
4보건복지부지정 전남대학교병원 심장질환치료기술개발특성화센터
A New Risk Score to Predict 1-Year Mortality in Acute Non-ST Elevation Myocardial Infarction
Jin Hee Park1,3, In Hyae Park2, Myung Ho Jeong1,4, Sook Ja Lee1,3, Soo Yong Jang1,4, Jae Young Cho1,4, Hae Chang Jeong1,4, Ki Hong Lee1,4, Keun-Ho Park1,4, Doo Sun Sim1,4, Kye Hun Kim1,4, Young Joon Hong1,4, Hyung Wook Park1,4, Ju Han Kim1,4, Young Keun Ahn1,4, Jeong Gwan Cho1,4, Jong Chun Park1,4
1The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Korea
2Department of Nursing, Chonnam National Univeristy College of Nursing, Korea
3Department of Nursing, Chonnam National University Hospital, Korea
4Heart Research Center of Chonnam National University Hospital Designated by Korean Ministry of Health and Welfare and Family Affairs, Gwangju, Korea
Corresponding Author: Myung Ho Jeong ,Tel: +82-62-220-6243, Fax: +82-62-228-7174, Email: myungho@chollian.net
Received: October 14, 2013;   Revised: January 13, 2014;   Accepted: June 5, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Accurate risk stratification is important in the management of patients with acute myocardial infarction (AMI). This study aimed to develop a new assessment tool for the prediction of 1-year mortality in patients with AMI, including biochemical markers. The author developed a new assessment tool (new risk score) that takes biochemical markers into account for 1-year mortality in patients with non-ST elevation myocardial infarction (NSTEMI) and identifies the risk factors related to 1-year mortality.
A total of 1,427 patients (65 ± 11.8 years of age, 985 males) who were admitted to the Chonnam National University Hospital with NSTEMI from November 2005 to March 2012 were retrospectively analyzed for score derivation. Multivariable Cox-regression analysis was used to select correlates of 1-year mortality that were subsequently weighted and integrated into an integer scoring system.
Seven variables selected from the initial multivariate model were weighted proportionally to their respective hazard ratio for 1-year mortality; age ≥ 65 years (2 points), N-terminal pro-brain natriuretic peptide (NT pro-BNP) > 991 pg/mL (1 point), baseline left ventricular ejection fraction < 40% (1 point), high sensitivity C-reactive protein (hs-CRP) > 3 mg/dL (1 point), glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 (1 point), heart rate > 82 beats/min (2 points), and final thrombolysis In myocardial infarction flow < 3 (2 points).
In NSTEMI patients, our new score that incorporates seven risk factors accurately predicts the 1-year mortality. Additionally, the biochemical markers hs-CRP, NT pro-BNP, and GFR are reliable predictors of 1-year mortality.
Keywords: Myocardial infarction; Mortality; Prognosis
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