Predictive value of the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes.

Details

Serval ID
serval:BIB_266F50CE5A99
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictive value of the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes.
Journal
International journal of cardiology
Author(s)
Stähli B.E., Wischnewsky M.B., Jakob P., Klingenberg R., Obeid S., Heg D., Räber L., Windecker S., Roffi M., Mach F., Gencer B., Nanchen D., Jüni P., Landmesser U., Matter C.M., Lüscher T.F., Maier W.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
01/11/2018
Peer-reviewed
Oui
Volume
270
Pages
7-13
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Pragmatic Clinical Trial
Publication Status: ppublish
Abstract
This study sought to investigate the predictive value of the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes (ACS). The ACEF score (age/left ventricular ejection fraction +1 [if creatinine > 176 μmol/L]) has been established in patients evaluated for coronary artery bypass surgery. Data on its predictive value in all-comer ACS patients undergoing percutaneous coronary intervention are scarce.
A total of 1901 patients prospectively enrolled in the Swiss ACS Cohort were included in the analysis. Optimal ACEF score cut-off values were calculated by decision tree analysis, and patients divided into low-risk (≤1.45), intermediate-risk (>1.45 and ≤2.0), and high-risk groups (>2.0). The primary endpoint was all-cause mortality. Major adverse cardiac and cerebrovascular events (MACCE) included all-cause death, non-fatal myocardial infarction, clinically indicated repeat coronary revascularization, definite stent thrombosis, and transient ischemic attack/stroke.
One-year rates of all-cause death increased across ACEF score groups (1.6% versus 5.6% versus 23.0%, p < 0.001). In multivariate analysis, the ACEF score was related with an increased risk of all-cause mortality (adjusted HR 3.53, 95% CI 2.90-4.31, p < 0.001), MACCE (adjusted HR 2.23, 95% CI 1.88-2.65, p < 0.001), and transient ischemic attack/stroke (adjusted HR 2.58, 95% CI 1.71-3.89, p < 0.001) at 1 year. Rates of Thrombolysis in Myocardial Infarction (TIMI) major and Global use of Strategies to Open Occluded Coronary Arteries (GUSTO) severe bleeding paralleled the increased ischemic risk across the groups (p < 0.001).
The ACEF score is a simple and useful risk stratification tool in patients with ACS referred for coronary revascularization.
Keywords
Acute Coronary Syndrome/blood, Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/surgery, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Creatinine/blood, Female, Humans, Male, Middle Aged, Mortality/trends, Percutaneous Coronary Intervention/trends, Predictive Value of Tests, Prospective Studies, Stroke Volume/physiology, Acute coronary syndrome, Percutaneous coronary intervention, Risk prediction
Pubmed
Web of science
Create date
25/06/2018 10:38
Last modification date
20/08/2019 13:05
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