Few simple and effective tools are available for determining the prognosis of 30-day
survivors after acute myocardial infarction. We aimed to assess whether the simple
age, creatinine, and ejection fraction (ACEF) score could predict 1-year mortality
of 12,000 post–myocardial infarction 30-day survivors who underwent percutaneous coronary
intervention. The ACEF score was computed as follows: (age/ejection fraction) + 1,
if the serum creatinine was >2 mg/dl. Accuracy was defined through receiver-operating
characteristics analysis and area under the curve (AUC) evaluation. Twelve risk factors
were selected and ranked according to their AUC value. Age, ejection fraction, and
serum creatinine levels indicated the best AUC value. The ACEF score was significantly
higher in the nonsurvivors (1.95 ± 0.82 vs 1.28 ± 0.50; p <0.001) and was an independent
predictor of 1-year mortality (adjusted hazard ratio 2.26; p <0.001). The best accuracy
was achieved by a prediction model including 12 risk factors (AUC = 0.80), but this
did not significantly differ compared with the AUC (0.79) of the ACEF score (p = ns).
Adjusted hazard ratios for 1-year mortality were 1 (reference), 3.11 (p <0.001), and
10.38 (p <0.001) for the ACEFLOW (ACEF score <1.0), ACEFMID (ACEF score 1.0 to 1.39), and ACEFHIGH (ACEF score ≥1.4) groups, respectively. The ACEF score may be a novel valid model
to stratify the 1-year mortality risk in 30-day survivors who underwent percutaneous
coronary intervention after acute myocardial infarction.
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Article Info
Publication History
Published online: February 11, 2015
Accepted:
February 4,
2015
Received in revised form:
February 4,
2015
Received:
October 24,
2014
Footnotes
See page 1172 for disclosure information.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
