Key result
The ALBO risk score accurately predicted new-onset atrial fibrillation in STEMI patients post-pPCI, yielding a C-statistic of 0.76 (95% CI 0.688-0.831; P<0.001) in the validation cohort.
Why the study?
Does the ALBO risk score predict the early incidence of new-onset atrial fibrillation in STEMI patients undergoing primary PCI?
Cohort (n=1,906)
Does the ALBO risk score predict the early incidence of new-onset atrial fibrillation in STEMI patients undergoing primary PCI?
Effect estimate: C-statistic 0.76 (95% CI 0.688-0.831)
p-value: p=< .001
The ALBO risk score, utilizing age, leucocyte count, BNP, and obesity, effectively predicts the early incidence of new-onset atrial fibrillation in STEMI patients post-primary PCI.
ALBO score may aid post-pPCI NOAF risk stratification in STEMI; leaves open prospective validation before clinical adoption.
AIM: New-onset atrial fibrillation (NOAF) is a complication not infrequent in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) and has been associated with worse in-hospital and long-term prognosis. We aimed to develop and validate a risk score based on common clinical risk factors and routine blood biomarkers to assess the early incidence of NOAF post-pPCI, before discharge. METHODS: The risk score for NOAF occurrence during hospitalisation (about 5 days) was developed in a cohort of 1135 consecutive STEMI patients undergoing pPCI while was externally validated in a temporal cohort of 771 STEMI patients. Biomarkers and clinical variables significantly contributing to predicting NOAF were assessed by multivariate Cox-regression analysis. RESULTS: /μL (2.65 [1.57-4.48], P < .001), brain natriuretic peptide (BNP) > 80 ng/L (2.37 [1.13-4.95], P = .02) and obesity (2.07 [1.09-3.92], P = .03). By summing the hazard ratios of these predictors we derived the ALBO (acronym derived from: Age, Leucocyte, BNP and Obesity) risk score which yielded high C-statistics in both the derivation (0.734 [0.675-0.793], P < .001) and validation cohort (0.76 [0.688-0.831], P < .001). In both cohorts, using Kaplan-Meier risk analysis, the ALBO score identified a tertile of patients at highest risk (ALBO >4 points), with percentages of NOAF incidence of 30.8% and 27.4% in the derivation and validation cohort, respectively. CONCLUSION: The ALBO risk score, comprising biomarkers and clinical variables that can be assessed in hospital setting, could help to identify high-risk patients for NOAF after pPCI so that a prompter action can be taken.
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Mazzone et al. (2018) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,906). ALBO risk score (Age, Leucocyte, BNP, Obesity) was evaluated on New-onset atrial fibrillation (NOAF) occurrence during hospitalisation (C-statistic 0.76, 95% CI 0.688-0.831, p=< .001). The ALBO risk score accurately predicted new-onset atrial fibrillation in STEMI patients post-pPCI, yielding a C-statistic of 0.76 (95% CI 0.688-0.831; P<0.001) in the validation cohort.
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