Prediction of Mortality in Hospital Survivors of STEMI: External Validation of a Novel Acute Myocardial Infarction Prognostic Score Academic Article uri icon

abstract

  • Introduction & objective Recently we developed and internally-validated the Soroka Acute Myocardial Infarction (SAMI) Score for prediction of all-cause long-term mortality (c-statistic 0.83-0.94) among hospital-survivors of AMI. We aimed to perform an external-validation of the SAMI score for long-term risk-stratification of STEMI patients undergoing PCI. Methods & Settings A prospective registry of 1,273 STEMI patients treated using primary PCI and discharged alive from Rabin Medical Center in Israel between 2004-2014 (age 60.8±12.5 years, 83% males) was utilized for the validation. Chi-square test and logistic regression were used for calibration, and c-statistic (ROC procedure) for discrimination assessment of the SAMI score. Results All-cause mortality following one- and 5-years post-discharge was 3.8% and 8.1%, respectively. SAMI score values ranged between (-5) and (+15) points (median 2-points). In a univariate analysis the SAMI score variables were significantly associated with 1- and 5-years mortality. Higher SAMI score was associated with increased risk for dying: a one-point increase was associated with OR of 1.33 (95%CI: 1.24-1.42, p<0.001) and 1.37 (95%CI: 1.29-1.44, p<0.001) for one- and 5-years mortality respectively. No statistically significant difference was found in the currently observed mortality rates by groups of SAMI score and the expected mortality rates as per the SAMI score index. The c-statistics were 0.818 and 0.83 for one- and 5-year mortality, respectively. Conclusions The SAMI score is a simple, robust and now also externally-validated prognostic tool for prediction of long-term all-cause mortality in hospital survivors of STEMI.

publication date

  • May 10, 2018