The ACEF (age, creatinine, ejection fraction) scorepredicts ischemic and bleeding outcomes of patients withacute coronary syndromes treated conservatively

Q: What are the key findings of this study?

The ACEF score independently predicted in-hospital death and major bleeding in conservatively treated ACS patients.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute coronary syndromes (n=1414). Intervention: Age, Creatinine, and Ejection Fraction (ACEF) score vs. Lower ACEF score / tertiles ( =1.504). Primary outcome: In-hospital death in conservatively treated patients (HR 1.53, 95% CI 1.27-1.85, p=<0.001).

Q: What does this research mean for the field?

The ACEF score independently predicts in-hospital mortality and major bleeding in acute coronary syndrome patients managed conservatively. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine whether the ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding complications in patients with acute coronary syndromes treated conservatively.

Artur Dziewierz; Zbigniew Siudak; Tomasz Rakowski; Wojciech Zasada; Katarzyna Krzanowska; Dariusz Dudek

doi:10.5114/pwki.2017.68209

January 1, 2017Advances in Interventional CardiologyOpen Access

The ACEF (age, creatinine, ejection fraction) scorepredicts ischemic and bleeding outcomes of patients withacute coronary syndromes treated conservatively

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Key result

Higher ACEF score is linked to ~53% higher in-hospital mortality in conservatively treated ACS.

HR 1.53
95% CI 1.27-1.85
P<0.001
n=1,414

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Why the study?

Does the ACEF score predict ischemic and bleeding outcomes in patients with acute coronary syndromes treated conservatively?

Key Points

To determine whether the ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding complications in patients with acute coronary syndromes treated conservatively.
Evaluated patients presenting with acute coronary syndromes who received conservative medical management rather than invasive intervention.
Assessed clinical risk using the ACEF score, which integrates patient age, serum creatinine levels, and left ventricular ejection fraction.
The ACEF score predicted ischemic and bleeding adverse outcomes in patients with acute coronary syndromes treated conservatively.

Study Design

Type

Observational (n=1,414)

Multicenter

Yes

Structured PICO

Does the ACEF score predict ischemic and bleeding outcomes in patients with acute coronary syndromes treated conservatively?

P

Population

1,414 consecutive patients (44.6% female) presenting with suspected acute coronary syndromes at 29 Polish community hospitals without on-site invasive facilities (1,102 treated conservatively), followed for the duration of their index hospitalization.

E

Exposure

ACEF (age, creatinine, ejection fraction) score assessment

O

Outcome

Ischemic and bleeding outcomeshard clinical

Main Result

Hazard Ratio: 1.53 (95% CI 1.27–1.85)

p-value: p=<0.001

Limitations

Mortality data for patients transferred for invasive treatment and long-term clinical follow-up data for all patients were not available
Enrollment period (2005-2006) may not correspond to current clinical practice with broad access to invasive treatment and newer antiplatelet/antithrombotic drugs
Direct calculation of the ACEF score was not possible in 29.6% (418) of patients due to missing variables, requiring multiple imputation
Performance of the ACEF score was not compared to other risk scores

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Implication

May inform prognosis in conservatively treated ACS; extends evidence to non-invasive settings but requires prospective validation.

Abstract

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Dziewierz A, Siudak Z, Rakowski T, Zasada W, Krzanowska K, Dudek D. The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2017;13(2):160-164. doi:10.5114/pwki.2017.68209. APA Dziewierz, A., Siudak, Z., Rakowski, T., Zasada, W., Krzanowska, K., & Dudek, D. (2017). The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 13(2), 160-164. https://doi.org/10.5114/pwki.2017.68209 Chicago Dziewierz, Artur, Zbigniew Siudak, Tomasz Rakowski, Wojciech Zasada, Katarzyna Krzanowska, and Dariusz Dudek. 2017. "The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 13 (2): 160-164. doi:10.5114/pwki.2017.68209. Harvard Dziewierz, A., Siudak, Z., Rakowski, T., Zasada, W., Krzanowska, K., and Dudek, D. (2017). The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 13(2), pp.160-164. https://doi.org/10.5114/pwki.2017.68209 MLA Dziewierz, Artur et al. "The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 13, no. 2, 2017, pp. 160-164. doi:10.5114/pwki.2017.68209. Vancouver Dziewierz A, Siudak Z, Rakowski T, Zasada W, Krzanowska K, Dudek D. The ACEF (age, creatinine, ejection fraction) score predicts ischemic and bleeding outcomes of patients with acute coronary syndromes treated conservatively. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2017;13(2):160-164. doi:10.5114/pwki.2017.68209.

Discussion

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Cite This Study

Dziewierz et al. (2017) conducted an observational in Acute coronary syndromes (n=1,414). Age, Creatinine, and Ejection Fraction (ACEF) score vs. Lower ACEF score / tertiles (<1.123, 1.123-1.503, >=1.504) was evaluated on In-hospital death in conservatively treated patients (HR 1.53, 95% CI 1.27-1.85, p=<0.001). The ACEF score independently predicted in-hospital death and major bleeding in conservatively treated ACS patients.

synapsesocial.com/papers/6a70e844af0c21e93928a27f https://doi.org/10.5114/pwki.2017.68209

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The ACEF (age, creatinine, ejection fraction) scorepredicts ischemic and bleeding outcomes of patients withacute coronary syndromes treated conservatively

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The ACEF (age, creatinine, ejection fraction) scorepredicts ischemic and bleeding outcomes of patients withacute coronary syndromes treated conservatively

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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