Key result
New model incorporating SOFA improves first-time AMI mortality prediction over SOFA alone to a ~0.76 C-index.
Why the study?
The study aimed to identify prognostic factors in patients with first-time acute myocardial infarction and establish a nomogram for prognostic modeling.
Does a new predictive model including the SOFA score improve prognostic accuracy for mortality in patients with first-time acute myocardial infarction compared to the SOFA score alone?
Cohort (n=985)
No
Does a new predictive model including the SOFA score improve prognostic accuracy for mortality in patients with first-time acute myocardial infarction compared to the SOFA score alone?
Absolute Event Rate: 0.761% vs 0.665%
A new prognostic model incorporating age, SOFA score, APSIII, sex, admission location, type of care unit, and vasopressin use improves mortality prediction in first-time AMI patients compared to the SOFA score alone.
May enhance mortality risk stratification in first-time AMI; leaves open need for external validation before clinical adoption.
OBJECTIVE: This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. METHODS: We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. RESULTS: An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. CONCLUSION: The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.
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Zheng et al. (2021) conducted a cohort in First-time acute myocardial infarction (n=985). New predictive model including SOFA score vs. SOFA model alone was evaluated on C-index for mortality prediction (test set). A new predictive model incorporating the SOFA score improved mortality prediction in first-time acute myocardial infarction compared to the SOFA model alone (test set C-index 0.761 vs 0.665).
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