Comparison of the integrated pulmonary index with cardiac risk scores in acute coronary syndromes

Abstract

Aim: In this study, we aimed to investigate the availability of the Integrated Pulmonary Index (IPI) score in predicting the risk of the major adverse cardiovascular event (MACE) in patients with acute coronary syndromes (ACS). Material and Methods: This study was planned as a prospective single-centered study and the cardiac risk scores and IPI were calculated on the arrival of patients with ACS in the emergency department. The Thrombolysis in Myocardial Infarction (TIMI), history, ECG, age, risk factors, troponin (HEART), and global registry of acute cardiac events (GRACE) risk scores were compared with the obtained IPI score. The MACE was defined as death within the last month since its arrival; IPI's prediction rates of MACE risk were investigated. Results: In the study, 381 patients were included and analyzed. MACE was detected in 105 (27.6%) patients. AUC values of TIMI, HEART, GRACE scores, and arrival high-sensitive cardiac troponin I in predicting MACE were 0.819, 0.737, 0.695 and 0.731, respectively, and statistically significant differences were found (p<0.001). There were negative correlations and statistically significant differences with the IPI, TIMI, HEART, and GRACE scores (p<0.001). The IPI score was found to predict MACE with 83.0% sensitivity and 74.3% specificity with >4 breakpoints (AUC=0.799). Discussion: Our study is the first study in the literature in which IPI predicts risk factors in the ACS. The IPI has been found to predict cardiovascular events in accordance with cardiac risk scores at 30-day follow-up, and it is beneficial for emergency physicians to use IPI with other cardiac risk scores in the prediction of MACE in ACS.