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dc.contributor.authorPocock, Stuart J
dc.contributor.authorHuo, Yong
dc.contributor.authorVan de Werf, Frans
dc.contributor.authorNewsome, Simon
dc.contributor.authorChin, Chee Tang
dc.contributor.authorVega, Ana Maria
dc.contributor.authorMedina, Jesús
dc.contributor.authorBueno, Héctor
dc.identifier.citationEur Heart J Acute Cardiovasc Care. 2019; 8(8):727-37es_ES
dc.description.abstractLong-term risk of post-discharge mortality associated with acute coronary syndrome remains a concern. The development of a model to reliably estimate two-year mortality risk from hospital discharge post-acute coronary syndrome will help guide treatment strategies. EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients, NCT01171404) and EPICOR Asia (EPICOR Asia, NCT01361386) are prospective observational studies of 23,489 patients hospitalized for an acute coronary syndrome event, who survived to discharge and were then followed up for two years. Patients were enrolled from 28 countries across Europe, Latin America and Asia. Risk scoring for two-year all-cause mortality risk was developed using identified predictive variables and forward stepwise Cox regression. Goodness-of-fit and discriminatory power was estimated. Within two years of discharge 5.5% of patients died. We identified 17 independent mortality predictors: age, low ejection fraction, no coronary revascularization/thrombolysis, elevated serum creatinine, poor EQ-5D score, low haemoglobin, previous cardiac or chronic obstructive pulmonary disease, elevated blood glucose, on diuretics or an aldosterone inhibitor at discharge, male sex, low educational level, in-hospital cardiac complications, low body mass index, ST-segment elevation myocardial infarction diagnosis, and Killip class. Geographic variation in mortality risk was seen following adjustment for other predictive variables. The developed risk-scoring system provided excellent discrimination (c-statistic=0.80, 95% confidence interval=0.79-0.82) with a steep gradient in two-year mortality risk: >25% (top decile) vs. ~1% (bottom quintile). A simplified risk model with 11 predictors gave only slightly weaker discrimination (c-statistic=0.79, 95% confidence interval =0.78-0.81). This risk score for two-year post-discharge mortality in acute coronary syndrome patients ( ) can facilitate identification of high-risk patients and help guide tailored secondary prevention measures.es_ES
dc.publisherSAGE Publicationses_ES
dc.subject.meshAcute Coronary Syndrome es_ES
dc.subject.meshAged es_ES
dc.subject.meshAsia es_ES
dc.subject.meshEurope es_ES
dc.subject.meshFemale es_ES
dc.subject.meshFibrinolytic Agents es_ES
dc.subject.meshFollow-Up Studies es_ES
dc.subject.meshHospitalization es_ES
dc.subject.meshHumans es_ES
dc.subject.meshLatin America es_ES
dc.subject.meshMale es_ES
dc.subject.meshMiddle Aged es_ES
dc.subject.meshMortality es_ES
dc.subject.meshMyocardial Infarction es_ES
dc.subject.meshPatient Discharge es_ES
dc.subject.meshPredictive Value of Tests es_ES
dc.subject.meshPrognosis es_ES
dc.subject.meshProspective Studies es_ES
dc.subject.meshRisk Factors es_ES
dc.subject.meshST Elevation Myocardial Infarction es_ES
dc.titlePredicting two-year mortality from discharge after acute coronary syndrome: An internationally-based risk score.es_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.identifier.journalEuropean heart journal. Acute cardiovascular carees_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Investigación Cardiovascular Traslacional Multidisciplinariaes_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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