Predictive value of the Canada Acute Coronary Syndrome risk score for post-acute myocardial infarction infection.

Abstract

BACKGROUND\nAlthough rare, infection in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) significantly increases mortality. Therefore, it is important to identify patients at high risk of infection. We aimed to validate the value of the Canada Acute Coronary Syndrome (C-ACS) risk score for predicting infection in such patients.\n\n\nMETHODS\nWe conducted a prospective cohort study. Consecutive patients with STEMI undergoing PCI at our hospital from January 2010 to June 2016 were enrolled . C-ACS risk score was calculated based on the following clinical parameters (1 point for each): age\xa0≥\xa075 years, Killip class >1, systolic blood pressure <100\u202fmmHg, and heart rate\xa0>\xa0100\xa0beats/min. The primary outcome was development of post-acute myocardial infarction (P-AMI) infection.\n\n\nRESULTS\nA total of 2198 patients were enrolled, of whom 424 (18.5%) developed infection. The incidence of infection, in-hospital mortality, and major adverse clinical events (MACE) were significantly higher in those with a C-ACS risk score ≥2. After adjusting for potential risk factors, C-ACS risk score remained a significant predictor of P-AMI infection (odds ratio [OR]\xa0=\xa02.27, 95% confidence interval [CI]\xa0=\xa01.92-2.67, p\xa0<\xa00.001), in-hospital mortality, and MACE. Receiver operating characteristic curves demonstrated the C-ACS risk score had good predictive value for P-AMI infection (area under the curve\xa0=\xa00.783, 95% CI\xa0=\xa00.759-0.806, P\xa0<\xa00.001), in-hospital mortality and MACE.\n\n\nCONCLUSIONS\nThe C-ACS risk score was a good predictor of P-AMI infection, and other clinical outcomes.