YuanHui Liu1, YiNing Dai1, JiaYing Chen2, Cheng Huang1, ChongYang Duan3, Shuai Shao1, HongHuan Chen1, Ling Xue1, DanQing Yu1, JiYan Chen1, Ning Tan1, PengCheng He4. 1. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. 2. Department of Internal Medicine, Ling Shui Li Autonomous County People's Hospital, Hainan, China. 3. Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China. 4. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. Electronic address: gdhpc100@126.com.
Abstract
BACKGROUND: Although rare, infection in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) significantly increases mortality. Therefore, it is important to identify patients at high risk of infection. We aimed to validate the value of the Canada Acute Coronary Syndrome (C-ACS) risk score for predicting infection in such patients. METHODS: We conducted a prospective cohort study. Consecutive patients with STEMI undergoing PCI at our hospital from January 2010 to June 2016 were enrolled . C-ACS risk score was calculated based on the following clinical parameters (1 point for each): age ≥ 75 years, Killip class >1, systolic blood pressure <100 mmHg, and heart rate > 100 beats/min. The primary outcome was development of post-acute myocardial infarction (P-AMI) infection. RESULTS: A total of 2198 patients were enrolled, of whom 424 (18.5%) developed infection. The incidence of infection, in-hospital mortality, and major adverse clinical events (MACE) were significantly higher in those with a C-ACS risk score ≥2. After adjusting for potential risk factors, C-ACS risk score remained a significant predictor of P-AMI infection (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.92-2.67, p < 0.001), in-hospital mortality, and MACE. Receiver operating characteristic curves demonstrated the C-ACS risk score had good predictive value for P-AMI infection (area under the curve = 0.783, 95% CI = 0.759-0.806, P < 0.001), in-hospital mortality and MACE. CONCLUSIONS: The C-ACS risk score was a good predictor of P-AMI infection, and other clinical outcomes.
BACKGROUND: Although rare, infection in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) significantly increases mortality. Therefore, it is important to identify patients at high risk of infection. We aimed to validate the value of the Canada Acute Coronary Syndrome (C-ACS) risk score for predicting infection in such patients. METHODS: We conducted a prospective cohort study. Consecutive patients with STEMI undergoing PCI at our hospital from January 2010 to June 2016 were enrolled . C-ACS risk score was calculated based on the following clinical parameters (1 point for each): age ≥ 75 years, Killip class >1, systolic blood pressure <100 mmHg, and heart rate > 100 beats/min. The primary outcome was development of post-acute myocardial infarction (P-AMI) infection. RESULTS: A total of 2198 patients were enrolled, of whom 424 (18.5%) developed infection. The incidence of infection, in-hospital mortality, and major adverse clinical events (MACE) were significantly higher in those with a C-ACS risk score ≥2. After adjusting for potential risk factors, C-ACS risk score remained a significant predictor of P-AMI infection (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.92-2.67, p < 0.001), in-hospital mortality, and MACE. Receiver operating characteristic curves demonstrated the C-ACS risk score had good predictive value for P-AMI infection (area under the curve = 0.783, 95% CI = 0.759-0.806, P < 0.001), in-hospital mortality and MACE. CONCLUSIONS: The C-ACS risk score was a good predictor of P-AMI infection, and other clinical outcomes.