A New Scoring System for Predicting Ventricular Arrhythmia Risk in Patients with Acute Myocardial Infarction

Abstract

Objective In this study, a risk score for ventricular arrhythmias (VA) were evaluated for predicting the risk of ventricular arrhythmia (VA) of acute myocardial infarction (AMI) patients. Methods Patients with AMI were divided into two sets according to whether VA occurred during hospitalization. Another cohort was enrolled for external validation. The area under the curve (AUC) of receiver operating characteristic (ROC) was calculated to evaluate the accuracy of the model. Results A total of 1493 eligible patients with AMI were enrolled as the training set, of whom 70 (4.7%) developed VA during hospitalization. In-hospital mortality was significantly higher in the VA set than in the non-VA set (31.4% vs 2.7%, P=0.001). The independent predictors of VA in patients with AMI including Killip grade ≥3, STEMI patients, LVEF <50%, frequent premature ventricular beats, serum potassium <3.5 mmol/L, type 2 diabetes, and creatinine level. The AUC of the model for predicting VT/VF in the training set was 0.815 (95% CI: 0.763–0.866). A total of 1149 cases were enrolled from Xuzhou Center Hospital as the external validation set. The AUC of the model in the external validation set for predicting VT/VF was 0.755 (95% CI: 0.687–0.823). Calibration curves indicated a good consistency between the predicted and the observed probabilities of VA in both sets. Conclusion We have established a clinical prediction risk score for predicting the occurrence of VA in AMI patients. The prediction score is easy to use, performs well and can be used to guide clinical practice.

Dapagliflozin reduces risk of heart failure rehospitalization in diabetic acute myocardial infarction patients: a propensity score-matched analysis

“…These damages may end up with HF and even sudden death. In addition, various ventricular arrhythmias may appear in the early stage after heart injury, which can also result in sudden death [ 33 ]. Therefore, patients with AMI are more likely to have serious complications in the early phase after AMI.…”

“…Renal injury in the early stages of AMI has been associated with a poor prognosis in the short term and can increase long-term mortality [ 40 ]. The development of malignant arrhythmias is an important cause of early death in AMI patients [ 33 ]. Early identification of patients at a high risk of various complications is important, and an artificial intelligence model for predicting acute kidney injury risk and a new scoring system for predicting ventricular arrhythmia risk have been developed [ 33 , 41 ].…”

“…The development of malignant arrhythmias is an important cause of early death in AMI patients [ 33 ]. Early identification of patients at a high risk of various complications is important, and an artificial intelligence model for predicting acute kidney injury risk and a new scoring system for predicting ventricular arrhythmia risk have been developed [ 33 , 41 ]. In our previous studies, we have also found that a low level of free triiodothyronine is independently associated with the short-term outcomes in patients with AMI [ 42 ].…”

Occult myocardial injury is prevalent amongst elderly patients in the hospital-at-home setting. A retrospective analysis of 213 patients

“…In the short-term, it is established that these patients have a higher risk for cardiovascular mortality and increased risk for MACE (Major Cardiovascular Events) during their hospitalization and shortly after discharge [ 19 ]. These patients' risk for MACE and mortality would be aggravated by concurrent electrolyte disturbances [ 12 ] (e.g., hypokalemia that bares increased risk for arrythmia during myocardial ischemia [ 21 , 22 ]) and pending arrythmias (e.g., prolongation of QTc (QT-corrected) [ 23 ], predisposing to potentially catastrophic ventricular arrythmias. These insights should impose actions on behalf of HAH services organizations: troponin levels should be monitored and accordingly, with respect to the service capacity and capabilities, should be referred to the in-hospital setting or monitored for electrolyte disturbances and/or cardiac conduction anomalies during their hospital stay.…”

Limitations and Future Directions for Risk Assessment of Ventricular Arrhythmia in Acute Myocardial Infarction [Letter]

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The article titled "A New Scoring System for Predicting Ventricular Arrhythmia (VA) Risk in Patients with Acute Myocardial Infarction (AMI)" by Sun et al has piqued our interest. 1 The objective of the study was to develop a risk score for predicting the occurrence of VA during hospitalization in patients with AMI. The study identified several independent predictors of VA, including a Killip grade of ≥3, STEMI patients, LVEF of <50%, frequent premature ventricular beats, a serum potassium level of <3.5 mmol/L, the presence of type 2 diabetes, and elevated creatinine levels.

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