Introduction: The effectiveness of treatment and prognosis of patients with type 1 myocardial infarction are highly correlated with time of diagnosis. This study aimed to develop a type 1 MI rapid screening scale (T1MIrs scale) suitable for emergency pre-diagnosis.
Methods: A total of 1928 patients who underwent coronary angiography were enrolled. Multivariate regression analysis was used to identify the independent risk factors of type 1 MI. And the T1MIrs scale was developed and evaluated according to the multivariate regression result.
Results: The incidence of type 1 MI was 23.3% in the population with suspected acute coronary syndrome. After 5 adjusting for relevant factors, MEWS score (OR = 1.809, 95%CI 1.623-2.016, P < .001), typical symptoms (OR = 9.826, 95%CI 7.379-13.084, P < .001), male (OR = 2.184, 95%CI 1.602-2.979, P < .001), age (OR = 1.021, 95%CI 1.009-1.033, P = .001), history of diabetes (OR = 2.174, 95%CI 1.594-2.963, P < .001) and current smoker (OR = 2.498, 95%CI 1.550-4.026, P < .001) were the independent risk factors for type 1 MI. The T1MIrs scale is established based on risk factors, with a range of 0-8 points. The incidence of type 1 MI is ascending with the scale (0.3% vs. 3.7% vs. 14.3% vs. 34.9% vs. 57% vs. 76.4% vs. 84.2% vs. 87.5% vs. 100%, P for trend <0.001).
Conclusions: Type 1 MI is common in patients with suspected acute coronary syndrome in emergency department. The T1MIrs scale could act as a rapid pre-examination triage of suspected population in emergency department, which is meaningful to screen out type 1 MI patients as soon as possible.
Keywords: Acute coronary syndrome; Modified early warning score; Pre-examination triage; Risk factors; Type 1 myocardial infarction.
Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.