Risk stratification for 1 year survival based on characteristics identified in the early hours of acute myocardial infarctionThe Western Washington Intracoronary Streptokinase Trial
作者:
MICHAEL STADIUS,
KATHRYN DAVIS,
CHARLES MAYNARD,
JAMES RITCHIE,
J. KENNEDY,
期刊:
Circulation
(OVID Available online 1986)
卷期:
Volume 74,
issue 4
页码: 703-711
ISSN:0009-7322
年代: 1986
出版商: OVID
数据来源: OVID
摘要:
We evaluated the relationship between baseline factors defined at 4.6 ± 2.1 hr after onset of acute myocardial infarction and 1 year survival in 245 patients entered in the Western Washington Intracoronary Streptokinase Trial. Univariate statistics identified a significant relationship between 10 of these factors and survival. Multivariate analysis identified three factors as being most closely related to survival: (1) left ventricular ejection fraction (LVEF) (p < .0001), (2) treatment with streptokinase (p = .03), and (3) location of infarction (p = .04). Mathematic models based on this analysis and applied to our patients identified high- and low-risk subgroups for 1 year mortality. Patients receiving standard, not interventional, therapy with anterior infarction and an LVEF of 50% or less and those with inferior infarction and an LVEF of 39% or less comprised the high-risk group. For patients receiving standard therapy, 1 year mortality was 41% in the high-risk group and 4% in the lowrisk group. The models illustrated the magnitude of benefit of streptokinase treatment and achievement of complete reperfusion for those at low and high risk. We conclude that LVEF determined in the first hours of acute myocardial infarction is the most important of all baseline factors for prediction of 1 year survival. Mathematic models based on left ventricular function measured as ejection fraction are useful for risk stratification in this setting.
点击下载:
PDF
(1833KB)
返 回