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Development of a Clinical Risk Score for Prediction of Life-Threatening Arrhythmia Events in Patients with ST Elevated Acute Coronary Syndrome after Primary Percutaneous Coronary Intervention

Author

Listed:
  • Thanutorn Wongthida

    (Office of Research and Knowledge Management, Chiang Rai Hospital, Chiang Rai 57000, Thailand)

  • Lalita Lumkul

    (Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
    Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand)

  • Jayanton Patumanond

    (Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand)

  • Wattana Wongtheptian

    (Cardiology Unit, Department of Medicine, Chiang Rai Hospital, Chiang Rai 57000, Thailand)

  • Dilok Piyayotai

    (Cardiology Unit, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 10120, Thailand)

  • Phichayut Phinyo

    (Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
    Department of Family Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
    Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai 50200, Thailand)

Abstract

ST-elevated acute coronary syndrome (STEACS) is a serious condition requiring timely treatment. Reperfusion with primary percutaneous coronary intervention (pPCI) is recommended and preferred over fibrinolysis. Despite its efficacy, lethal complications, such as life-threatening arrhythmia (LTA), are common in post-PCI patients. Although various risk assessment tools were developed, only a few focus on LTA prediction. This study aimed to develop a risk score to predict LTA events after pPCI. A risk score was developed using a retrospective cohort of consecutive patients with STEACS who underwent pPCI at Chiangrai Prachanukroh Hospital from January 2012 to December 2016. LTA is defined as the occurrence of malignant arrhythmia that requires advanced cardiovascular life support (ACLS) within 72 h after pPCI. Logistic regression was used for model derivation. Among 273 patients, 43 (15.8%) developed LTA events. Seven independent predictors were identified: female sex, hemoglobin < 12 gm/dL, pre- and intra-procedural events (i.e., respiratory failure and pulseless arrest), IABP insertion, intervention duration > 60 min, and desaturation after pPCI. The LTA score showed an AuROC of 0.93 (95%CI 0.90, 0.97). The score was categorized into three risk categories: low (<2.5), moderate (2.5–4), and high risk (>4) for LTA events. The LTA score demonstrated high predictive performance and potential clinical utility for predicting LTA events after pPCI.

Suggested Citation

  • Thanutorn Wongthida & Lalita Lumkul & Jayanton Patumanond & Wattana Wongtheptian & Dilok Piyayotai & Phichayut Phinyo, 2022. "Development of a Clinical Risk Score for Prediction of Life-Threatening Arrhythmia Events in Patients with ST Elevated Acute Coronary Syndrome after Primary Percutaneous Coronary Intervention," IJERPH, MDPI, vol. 19(4), pages 1-18, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:1997-:d:746587
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    References listed on IDEAS

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    1. Andrew J. Vickers & Elena B. Elkin, 2006. "Decision Curve Analysis: A Novel Method for Evaluating Prediction Models," Medical Decision Making, , vol. 26(6), pages 565-574, November.
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