Author + information
- Hector Gonzalez-Pacheco,
- Rafael Bojalil,
- Luis Amezcua-Guerra,
- Julio Sandoval,
- Guering Eid-Lidt,
- Alexandra Arias-Mendoza,
- Francisco Azar Manzur,
- Amada Alvarez,
- Alfredo Altamirano,
- Jose Luis Briseño De La Cruz and
- Carlos Martinez-Sanchez
Background: Accurate assessment of the inflammatory status of patients during acute coronary syndrome (ACS) has come to be of great importance in their risk classification and research of new anti-inflammatory therapies. We sought to derive and internally validate a simple inflammation-based risk score that included high-sensitivity C-reactive protein (≥10 mg/L), white blood cell count (≥10 × 103/μL) and serum albumin level (≤3.5 g/dL) at admission for predicting in-hospital mortality in the spectrum of ACS.
Methods: This is a retrospective cohort study of 7,410 patients with ACS. We randomly assigned patients into derivation (66.7%) and validation (33.3%) cohorts. The score was calculated depending on the combination of biomarkers of inflammation and four categories of risk score were defined; 0, 1, 2 and 3.
Results: Unadjusted in-hospital mortality was significantly different across the four risk groups in the derivation cohort (1.8%, 3.3%, 6.2%, and 17.5%, for 0, 1, 2 and 3 risk score, respectively, P<0.0001, C-statistic, 0.70). These results were similar in the validation cohort (1.5%, 3.5%, 6.5%, and 18.0%, respectively, P<0.0001, C-statistic, 0.71). After multivariate adjustment, the score 3 was associated with a 3.34-fold increase in in-hospital mortality risk and was the most powerful predictor of mortality. The interaction with GRACE risk score identifies a subset of very high-risk patients and highlights the absence of inflammation as a low mortality risk, regardless of the GRACE risk score.
Conclusions: Our data suggest that a risk score based on biomarkers of inflammation readily available at admission in ACS predicts in-hospital mortality and may be a supplementary tool to clinical risk scores.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-335
- 2017 American College of Cardiology Foundation