Importance of EuroSCORE-II in the Development of Acute Ischemic Heart Failure After Acute Anterior ST Elevation Myocardial Infarction

Abstract

Introduction: We aimed to evaluate the importance of the EuroSCORE-II (ES-II) risk-scoring system in predicting the development of acute ischemic heart failure (AIHF) after acute anterior ST segment elevation myocardial infarction (A-STEMI).

Patients and Methods: A total of 261 patients (206 male; mean age, 63.5 ± 14.2 years) admitted to our centre with A-STEMI between April 2012 and January 2013 were included in the study. The patients were divided into two groups according to their clinical findings and were prospectively followed during the hospitalisation period for the development of cardiac morbidity and mortality. These groups were the AIHF group (n= 69) and non-AIHF group (n= 192). For the diagnosis of AIHF, we considered the recommendations of the European Society of Cardiology Guidelines on Heart Failure and the Framingham criteria.

Results: According to our results, the morbidity and mortality rates were higher in the AIHF group. Symptom-to-balloon time, ejection fraction (EF), glomerular filtration rate (gfr), no-reflow phenomenon, left main coronary artery disease and ES-II, which are the predictors of the development of AIHF, were determined via logistic regression analysis. ROC analysis revealed that symptom-to-balloon time > 209.5 min, EF < 36.5%, gfr < 68.5 mg/dL/1.73 m² and ES-II > 4.9% were the cut-off values in the development of AIHF.

Conclusion: Patients with A-STEMI complicated by AIHF have significantly high mortality rates. With the pre-estimation of the development of AIHF, complication rates can be reduced. For this purpose, ES-II score > 4.9% can be used as a predictor of AIHF after A-STEMI.

Keywords

• Coronary artery disease,ST elevation myocardial infarction,EuroSCORE-II,acute ischemic heart failure

Akut Anterior Miyokart İnfarktüsü Sonrası Akut İskemik Kalp Yetersizliği Gelişimini Öngörmede EuroSCORE-II’nin Önemi

Abstract

Giriş: Akut anterior ST yükselmeli miyokart infarktüsü (A-STEMİ) sonrası akut iskemik kalp yetersizliği (AİKY) gelişimini öngörmede EuroSCORE-II skorlama sisteminin önemini değerlendirmeyi amaçladık.

Hastalar ve Yöntem: Çalışmaya Nisan 2012-Ocak 2013 tarihleri arasında merkezimize A-STEMİ nedeniyle kabul edilen 261 hasta (206 erkek, ortalama yaş 63.5 ± 14.2) dahil edildi. Hastalar klinik bulgularına göre iki farklı gruba ayrıldı ve hastanede yatış periyodu süresince kardiyak morbidite ve mortalite gelişimi bakımından prospektif olarak takip edildi. Bu gruplar AİKY grubu ((n= 69) ve non-AİKY grupları (n= 192) idi. AİKY tanısı koyabilmek için Avrupa Kardiyoloji Cemiyeti kalp yetersizliği klavuzu ve Framingham kriterleri göz önünde bulunduruldu.

Bulgular: Çalışmamız sonuçlarına göre AİKY grubunda morbidite ve mortalite daha yüksekti. Regresyon analizleri sonuçlarına göre semptom-balon zamanı, ejeksiyon fraksiyonu, no-reflow fenomeni, sol ana koroner hastalığı, üç damar koroner arter hastalığı, SYNTAX skoru ve ES-II’nin AİKY gelişiminin prediktörleri oldukları belirlendi. ROC analizlerinin sonuçlarına gore semptom-kapı zamanının > 229.5 dakika, EF < %36.5, SYNTAX skoru > 27.75 ve EsII > %4.9 değerlerinin AİKY gelişimini öngördürebilecek sınır değerler oldukları belirlendi.

Sonuç: AİKY gelişen A-STEMİ’li hastalarda mortalite oranları artmaktadır. AİKY gelişiminin önceden öngörülmesi kardiyak komplikasyonları azaltabilir. Bu amaçla Es-II’nin > %4.9 olması A-STEMİ sonrası AİKY gelişimim öngördürücüsü olarak kullanılabilir.

Keywords

• Koroner arter hastalığı,acut anterior ST yükselmeli miyokart infarktüsü,EuroSCORE-II,akut iskemik kalp yetersizliği

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