The CAMI-score: A Novel Tool derived From CAMI Registry to Predict In-hospital Death among Acute Myocardial Infarction Patients

Abstract

Risk stratification of patients with acute myocardial infarction (AMI) is of clinical significance. Although there are many existing risk scores, periodic update is required to reflect contemporary patient profile and management. The present study aims to develop a risk model to predict in-hospital death among contemporary AMI patients as soon as possible after admission. We included 23417 AMI patients from China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014 and extracted relevant data. Patients were divided chronologically into a derivation cohort (n = 17563) to establish the multivariable logistic regression model and a validation cohort (n = 5854) to validate the risk score. Sixteen variables were identified as independent predictors of in-hospital death and were used to establish CAMI risk model and score: age, gender, body mass index, systolic blood pressure, heart rate, creatinine level, white blood cell count, serum potassium, serum sodium, ST-segment elevation on ECG, anterior wall involvement, cardiac arrest, Killip classification, medical history of hypertension, medical history of hyperlipidemia and smoking status. Area under curve value of CAMI risk model was 0.83 within the derivation cohort and 0.84 within the validation cohort. We developed and validated a risk score to predict in-hospital death risk among contemporary AMI patients.

Development of an optimized risk score to predict short‐term death among acute myocardial infarction patients in rural China

“…However, the impact of blood glucose in the context of MI is complex, involving both protective and deleterious effects on the myocardium 29 . This may explain why blood glucose was not included in the GRACE or CAMI risk scores 10,30 …”

“…29 This may explain why blood glucose was not included in the GRACE or CAMI risk scores. 10,30 Pulmonary hypertension is frequently observed following AMI, 31 and elevated PASP after AMI is often associated with poor prognosis. 32,33 Indeed, PASP was proved to be a strong independent predictor of short-term death in a previous study.…”

“…Many risk models of in‐hospital or short‐term mortality have been developed among patients with acute coronary syndrome 6‐7,8,9,10,11 . Among them, the Global Registry in Acute Coronary Events (GRACE) score is the most commonly used to predict short‐term death 12 .…”

“…Many risk models of in-hospital or short-term mortality have been developed among patients with acute coronary syndrome. [6][7]8,9,10,11 Among them, the Global Registry in Acute Coronary Events (GRACE) score is the most commonly used to predict short-term death. 12 However, the GRACE score was developed at a time when patient characteristics and management differed significantly from current practice, and few participants were from Asia.…”

Pretreatment with antiplatelet drugs improves the cardiac function after myocardial infarction without reperfusion in a mouse model

“…The China PEACE-Retrospective Acute Myocardial Infarction Study [13] showed that the proportion of patients who did not receive reperfusion was 44.8% in 2001 and 45.0% in 2011. The China AMI (CAMI) registry [14] showed that among patients with non-STEMI, 9.3% received an early invasive approach. Among patients with STEMI, only 43.0% were treated with primary PCI; besides, 9.9% received thrombolytic therapy.…”