Key result
The Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II successfully stratified the risk of major adverse cardiovascular events in patients with acute myocardial infarction, with AUCs ranging from 0.60 to 0.63.
Why the study?
Because myocardial infarction and ischemic stroke share atherosclerotic pathophysiology, ischemic stroke risk-scoring models may be applicable for risk stratification in patients with acute MI.
Do stroke risk scores (Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II) predict major adverse cardiovascular events in patients with acute myocardial infarction?
Observational (n=2,016)
Yes
Do stroke risk scores (Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II) predict major adverse cardiovascular events in patients with acute myocardial infarction?
Effect estimate: AUC 0.60-0.63
Stroke risk scores (Fukuoka, Essen, SPI-II) are useful for stratifying the risk of subsequent major adverse cardiovascular events in patients who have survived an acute myocardial infarction.
AIMS: Several risk-scoring models, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, have been developed to predict recurrent cerebrovascular events in patients with ischemic stroke. As myocardial infarction (MI) and ischemic stroke are both atherosclerotic diseases, these scoring models in the field of cerebrovascular disease may be applicable and useful for risk stratification in patients with acute MI. We therefore evaluated the diagnostic ability and clinical applicability of these stroke risk scores in predicting atherosclerotic events after acute MI. METHODS: This multicenter retrospective study included 2016 patients with acute MI who underwent percutaneous coronary intervention and survived to discharge. The three risk-scoring models were calculated, and their diagnostic ability for major adverse cardiovascular events (MACE) after discharge, a composite of cardiovascular death, recurrent MI, and ischemic stroke, was evaluated. RESULTS: During the median follow-up of 523 days, 218 (10.8%) patients experienced MACE after discharge. High values for Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II were progressively associated with an increased risk of MACE after discharge. Overall, the diagnostic abilities of the three risk scores were similar. CONCLUSIONS: Risk prediction models in the field of ischemic stroke, including the Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II, were useful in stratifying MACE risk in patients with acute MI. Risk-scoring models for atherosclerotic cardiovascular disease may be applicable to patient populations with other cardiovascular diseases in different arterial territories.
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Goto et al. (2024) conducted an observational in Acute Myocardial Infarction (n=2,016). Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II was evaluated on Major adverse cardiovascular events (MACE) after discharge, a composite of all-cause death, recurrent MI, and ischemic stroke (AUC 0.60-0.63). The Fukuoka Stroke Risk Score, Essen Stroke Risk Score, and Stroke Prognosis Instrument II successfully stratified the risk of major adverse cardiovascular events in patients with acute myocardial infarction, with AUCs ranging from 0.60 to 0.63.
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