Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

INTRODUCTION: In patients who have undergone interventional cardiac procedures, the risk of bleeding is higher than in patients who received conservative treatment due to multiple medications and comorbidities. AIM: This study aimed to evaluate the usefulness of the age, creatinine and ejection frac...

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Detalles Bibliográficos
Autores principales: Ösken, Altuğ, Hacı, Recep, Şekerci, Sena Sert, Asarcıklı, Lale Dinç, Yüksel, Gizem, Ceylan, Büşra, Dayı, Şennur Ünal, Çam, Neşe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
Materias:
Original Paper
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356837/
https://www.ncbi.nlm.nih.gov/pubmed/34400919
http://dx.doi.org/10.5114/aic.2021.107495
Descripción
Sumario:INTRODUCTION: In patients who have undergone interventional cardiac procedures, the risk of bleeding is higher than in patients who received conservative treatment due to multiple medications and comorbidities. AIM: This study aimed to evaluate the usefulness of the age, creatinine and ejection fraction (ACEF) score for predicting bleeding events and to compare short- and long-term clinical outcomes according to the ACEF score in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) with bail-out tirofiban therapy (BOTT). MATERIAL AND METHODS: A total of 2,543 patients were included and divided into three groups according to the following ACEF score tertiles: T1 (ACEF(low) ≤ 1.033), T2 (1.033 < ACEF(mid) ≤ 1.371), and T3 (ACEF(high) > 1.371). The main outcomes measured were the incidence rates of relevant bleeding events and mortality within 30 days and 3 years after the procedure. RESULTS: A total of 73 (2.9%) patients had Bleeding Academic Research Consortium bleeding events of grades 3, 4 or 5 and 104 (4%) patients died in a 30-day period. The ACEF score was effective at predicting 30-day bleeding (area under the receiver operating characteristic curve (AUC): 0.658, 95% confidence interval (CI): 0.579–0.737; p < 0.001), 30-day mortality (AUC = 0.701, 95% CI: 0.649–0.753; p < 0.001) and 3-year mortality (AUC = 0.778, 95% CI: 0.748–0.807; p < 0.001) events. Considering the ACEF score tertiles, T3 patients presented greater 30-day bleeding (1.6%, 2.8% and 4.1%; odds ratio (OR) = 2.56, 95% CI: 1.37–4.80), 30-day mortality (1.7%, 3.5% and 7.1%; OR = 4.53, 95% CI: 2.51–8.18) and 3-year mortality (6.4%, 11% and 19.8%; hazard ratio = 3.56, 95% CI: 2.58–4.91) risks. CONCLUSIONS: The ACEF score is a user-friendly tool with excellent predictive value for bleeding events and mortality in patients undergoing pPCI with BOTT.

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