A poor outcome prediction scale in ST-segment elevation myocardial infarction patients undergoing emergency percutaneous coronary intervention

AIM: To make a prediction scale using a set of clinical and laboratory prognostic variables for patients with ST-segment elevation myocardial infarction (STEMI) on their electrocardiograms (ECG) who have undergone percutaneous coronary intervention/MATERIAL AND METHODS: The study enrolled 154 STEMI patients who had undergone percutaneous coronary angioplasty with stenting of the artery supplying blood to the area of an ischemia. Enzyme immunoassay was used to determine the levels of cytokines and selectins on days 1 and 10/RESULTS: During a year, the authors identified the following independent risk factors of a poor outcome (PO): symptoms of Killip Class III-IV heart failure; a history of smoking; rhythm and conduction disturbances on day 1 of the disease; tumor necrosis factor-α levels determined on day 1 of the disease; IL-1α and sP-selectin levels measured on day 10. In the made prediction scale, a score was assigned to each independent prognostic variable to estimate the risk of PO. The borderline values of summing the scores, which divided the patients into groups at low, moderate, and high risk for PO, were determined for the practical application of the scale, by using the receiver operating characteristic curve (ROC) analysis. The performance of the model was tested using an independent sample of STEMI patients (n=50). The probability that the classification of the model was correct amounted to 89.6% (p