Key result
The CAMI-NSTEMI risk score accurately predicted in-hospital mortality in NSTEMI patients, demonstrating superior diagnostic performance compared to the GRACE risk score (AUC 0.81 vs. 0.72).
Why the study?
Does the CAMI-NSTEMI risk score improve the prediction of in-hospital mortality in NSTEMI patients compared to the GRACE risk score?
Observational (n=5,775)
Yes
Does the CAMI-NSTEMI risk score improve the prediction of in-hospital mortality in NSTEMI patients compared to the GRACE risk score?
Effect estimate: AUC 0.81 (95% CI 0.78-0.83)
Absolute Event Rate: 0.81% vs 0.72%
p-value: p=<0.01
The CAMI-NSTEMI score is a novel, registry-derived tool that accurately predicts in-hospital mortality in NSTEMI patients, demonstrating superior diagnostic performance compared to the GRACE score.
May support NSTEMI risk stratification; leaves open prospective validation against GRACE.
BACKGROUND: Accurate risk stratification of non-ST segment elevation myocardial infarction (NSTEMI) patients is important due to great variability in mortality risk, but, to date, no prediction model has been available. The aim of this study was therefore to establish a risk score to predict in-hospital mortality risk in NSTEMI patients. METHODS AND RESULTS: We enrolled 5,775 patients diagnosed with NSTEMI from the China Acute Myocardial Infarction (CAMI) registry and extracted relevant data. Patients were divided into a derivation cohort (n=4,332) to develop a multivariable logistic regression risk prediction model, and a validation cohort (n=1,443) to test the model. Eleven variables independently predicted in-hospital mortality and were included in the model: age, body mass index, systolic blood pressure, Killip classification, cardiac arrest, electrocardiogram ST-segment depression, serum creatinine, white blood cells, smoking status, previous angina, and previous percutaneous coronary intervention. In the derivation cohort, the area under curve (AUC) for the CAMI-NSTEMI risk model and score was 0.81 and 0.79, respectively. In the validation cohort, the score also showed good discrimination (AUC, 0.86). Diagnostic performance of CAMI-NSTEMI risk score was superior to that of the GRACE risk score (AUC, 0.81 vs. 0.72; P<0.01). CONCLUSIONS: The CAMI-NSTEMI score is able to accurately predict the risk of in-hospital mortality in NSTEMI patients.
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Fu et al. (2018) conducted an observational in Non-ST segment elevation myocardial infarction (NSTEMI) (n=5,775). CAMI-NSTEMI risk score vs. GRACE risk score was evaluated on In-hospital mortality prediction (Area Under the Curve) (AUC 0.81, 95% CI 0.78-0.83, p=<0.01). The CAMI-NSTEMI risk score accurately predicted in-hospital mortality in NSTEMI patients, demonstrating superior diagnostic performance compared to the GRACE risk score (AUC 0.81 vs. 0.72).
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