Simple risk score based on the China Acute Myocardial Infarction registry for predicting in-hospital mortality among patients with non-ST-segment elevation myocardial infarction: results of a prospective observational cohort study

BMJ Open. 2019 Sep 12;9(9):e030772. doi: 10.1136/bmjopen-2019-030772.

Abstract

Objectives: To simplify our previous risk score for predicting the in-hospital mortality risk in patients with non-ST-segment elevation myocardial infarction (NSTEMI) by dropping laboratory data.

Design: Prospective cohort.

Setting: Multicentre, 108 hospitals across three levels in China.

Participants: A total of 5775 patients with NSTEMI enrolled in the China Acute Myocardial Infarction (CAMI) registry.

Primary outcome measures: In-hospital mortality.

Results: The simplified CAMI-NSTEMI (SCAMI-NSTEMI) score includes the following nine variables: age, body mass index, systolic blood pressure, Killip classification, cardiac arrest, ST-segment depression on ECG, smoking status, previous angina and previous percutaneous coronary intervention. Within both the derivation and validation cohorts, the SCAMI-NSTEMI score showed a good discrimination ability (C-statistics: 0.76 and 0.83, respectively); further, the SCAMI-NSTEMI score had a diagnostic performance superior to that of the Global Registry of Acute Coronary Events risk score (C-statistics: 0.78 and 0.73, respectively; p<0.0001 for comparison). The in-hospital mortality increased significantly across the different risk groups.

Conclusions: The SCAMI-NSTEMI score can serve as a useful tool facilitating rapid risk assessment among a broader spectrum of patients admitted owing to NSTEMI.

Trial registration number: NCT01874691.

Keywords: NSTEMI; in-hospital mortality; updated risk score.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • China / epidemiology
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / surgery
  • Electrocardiography / methods
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Non-ST Elevated Myocardial Infarction* / diagnosis
  • Non-ST Elevated Myocardial Infarction* / mortality
  • Non-ST Elevated Myocardial Infarction* / physiopathology
  • Non-ST Elevated Myocardial Infarction* / therapy
  • Prognosis
  • Registries / statistics & numerical data
  • Research Design
  • Risk Assessment / methods*
  • Risk Factors
  • Smoking / epidemiology

Associated data

  • ClinicalTrials.gov/NCT01874691