Key result
The novel BACEF score, incorporating serum albumin, age, serum creatinine, and LVEF, accurately predicted 4-year mortality in AMI patients with an AUC of 0.83, outperforming the ACEF, ACEFII, and GRACE scores.
Why the study?
Mortality from acute myocardial infarction remains substantial, prompting the development of a novel simple and easy-to-use risk score.
Does the BACEF score improve 4-year mortality risk prediction compared to ACEF, ACEFII, and GRACE scores in patients with AMI undergoing PCI?
Cohort (n=1,326)
No
Does the BACEF score improve 4-year mortality risk prediction compared to ACEF, ACEFII, and GRACE scores in patients with AMI undergoing PCI?
The novel BACEF score, utilizing only four objective variables (serum albumin, age, serum creatinine, and LVEF), provides a simple and superior 4-year mortality risk stratification tool for AMI patients compared to existing scores like GRACE.
Answers are grounded in this paper and cite their sources.
May enhance 4-year mortality prediction in AMI; hypothesis-generating and requires prospective validation before practice change.
Aims Mortality from acute myocardial infarction (AMI) remains substantial. The current study is aimed at developing a novel simple and easy-to-use risk score for AMI. Methods The CatLet extended validation trial (ChiCTR2000033730) and the CatLet validation trial (ChiCTR-POC-17013536), both being registered with chictr.org, served as the derivation and validation datasets, respectively. The derivation dataset included 1018 patients, and the validation dataset included 308 ones. They all suffered from AMI and underwent percutaneous intervention (PCI). The 4-year follow-up was 97% completed for the derivation dataset, and 100% completed for the validation dataset. The endpoint was all-cause death. Lasso regression analysis was used for covariate selection and coefficient estimation. Results Of 26 candidate predictor variables, four strongest predictors for 4-year mortality were included in the BACEF score (serum albumin, age, serum creatinine, and LVEF). This score was well calibrated and yielded an AUC (95%CI) statistics of 0.84(0.80-0.87) in internal validation, 0.89(0.83-0.95) in internal-external (temporal) validation, and 0.83(0.77-0.89) in external validation. Notably, it outperformed the ACEF, ACEFII, GRACE risk scores (0.83(0.77-0.89) vs 0.81(0.75-0.88); 0.83(0.77-0.89) vs 0.79(0.73-0.86); and 0.83(0.77-0.89) vs 0.79(0.72-0.86), respectively). Conclusions A simple risk score for 4-year mortality risk stratification was developed, extensively validated, and calibrated in patients with AMI. This novel BACEF score outperformed the ACEF, ACEFII, and GRACE scores and may be a useful risk stratification tool for patients with AMI. One-sentence summary A novel simple risk score with an acronym of BACEF, including only four risk factors of serum albumin, age, serum creatinine, and LVEF, has been developed, and outperformed the ACEF, ACEFII, and GRACE scores in terms of four-year mortality prediction for patients with acute myocardial infarction. Take-home figure
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Ge et al. (2022) conducted a cohort in Acute myocardial infarction (n=1,326). BACEF score (serum albumin, age, serum creatinine, and LVEF) vs. ACEF, ACEFII, and GRACE scores was evaluated on 4-year all-cause mortality prediction (AUC) (AUC 0.83, 95% CI 0.77-0.89). The novel BACEF score, incorporating serum albumin, age, serum creatinine, and LVEF, accurately predicted 4-year mortality in AMI patients with an AUC of 0.83, outperforming the ACEF, ACEFII, and GRACE scores.
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