Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina
Background: A score based on age, creatinine level, and ejection fraction as well as hematocrit value and the presence of emergency surgery (ACEF-II) has been proposed to have predictive value for risk stratification in cardiac surgery. This study aimed to evaluate its utility in patients with non–S...
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| Language: | English |
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The Texas Heart Institute
2024-12-01
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| Series: | Texas Heart Institute Journal |
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| Online Access: | https://thij.kglmeridian.com/downloadpdf/view/journals/thij/51/2/article-e238310.pdf |
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| author | Burak Ayça, MD Yasin Yüksel, MD Cennet Yildiz, MD |
| author_facet | Burak Ayça, MD Yasin Yüksel, MD Cennet Yildiz, MD |
| author_sort | Burak Ayça, MD |
| collection | DOAJ |
| description | Background:
A score based on age, creatinine level, and ejection fraction as well as hematocrit value and the presence of emergency surgery (ACEF-II) has been proposed to have predictive value for risk stratification in cardiac surgery. This study aimed to evaluate its utility in patients with non–ST-segment elevation myocardial infarction and unstable angina (NSTEMI-ACS) to predict 1-year major adverse cardiac events (MACE).
Methods:
In all, 768 patients with NSTEMI-ACS were enrolled in the study. After propensity score matching, the MACE and control groups comprised 168 patients each. Blood samples were drawn from patients during emergency department admission and hospitalization. The Global Registry of Acute Coronary Events, Acute Coronary Treatment and Intervention Outcome Network Intensive Care Unit risk, ACEF, and ACEF-II scores of each patient were evaluated.
Results:
Mean (SD) age of the study population was 63.07 (12.39) years; 547 (71.2%) patients were male. After propensity score matching for 7 variables, a comparison of the matched groups revealed that patients with MACE had higher heart rates and rates of ST-segment deviation, cardiac arrest, and creatinine levels and lower left ventricular ejection fraction and albumin, hemoglobin, hematocrit, systolic blood pressure, and oxygen saturation values. Multivariate logistic regression analysis revealed that ACEF-II score had the highest odds ratio of the evaluated scores, at 1.41 (95% CI, 1.12-1.81; P = .005). The ACEF score did not reach statistical significance for the prediction of 1-year MACE according to multivariate analysis. In addition to type of risk score, left ventricular ejection fraction and heart rate had predictive value for 1-year MACE. An ACEF-II score cutoff of 1.82 predicted 1-year MACE, with a sensitivity of 61.2% and a specificity of 76.2%.
Conclusion:
ACEF-II score, which is easy to calculate, could be used to predict 1-year MACE in patients with NSTEMI-ACS. |
| format | Article |
| id | doaj-art-0a0eb12f73bf496ca8a8ba9873857116 |
| institution | OA Journals |
| issn | 1526-6702 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The Texas Heart Institute |
| record_format | Article |
| series | Texas Heart Institute Journal |
| spelling | doaj-art-0a0eb12f73bf496ca8a8ba98738571162025-08-20T02:38:17ZengThe Texas Heart InstituteTexas Heart Institute Journal1526-67022024-12-0151211210.14503/THIJ-23-8310i1526-6702-51-2-e238310Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable AnginaBurak Ayça, MD0Yasin Yüksel, MD1Cennet Yildiz, MD21 Cardiology Department, Istanbul Training and Research Hospital, Istanbul, Turkey1 Cardiology Department, Istanbul Training and Research Hospital, Istanbul, Turkey1 Cardiology Department, Istanbul Training and Research Hospital, Istanbul, TurkeyBackground: A score based on age, creatinine level, and ejection fraction as well as hematocrit value and the presence of emergency surgery (ACEF-II) has been proposed to have predictive value for risk stratification in cardiac surgery. This study aimed to evaluate its utility in patients with non–ST-segment elevation myocardial infarction and unstable angina (NSTEMI-ACS) to predict 1-year major adverse cardiac events (MACE). Methods: In all, 768 patients with NSTEMI-ACS were enrolled in the study. After propensity score matching, the MACE and control groups comprised 168 patients each. Blood samples were drawn from patients during emergency department admission and hospitalization. The Global Registry of Acute Coronary Events, Acute Coronary Treatment and Intervention Outcome Network Intensive Care Unit risk, ACEF, and ACEF-II scores of each patient were evaluated. Results: Mean (SD) age of the study population was 63.07 (12.39) years; 547 (71.2%) patients were male. After propensity score matching for 7 variables, a comparison of the matched groups revealed that patients with MACE had higher heart rates and rates of ST-segment deviation, cardiac arrest, and creatinine levels and lower left ventricular ejection fraction and albumin, hemoglobin, hematocrit, systolic blood pressure, and oxygen saturation values. Multivariate logistic regression analysis revealed that ACEF-II score had the highest odds ratio of the evaluated scores, at 1.41 (95% CI, 1.12-1.81; P = .005). The ACEF score did not reach statistical significance for the prediction of 1-year MACE according to multivariate analysis. In addition to type of risk score, left ventricular ejection fraction and heart rate had predictive value for 1-year MACE. An ACEF-II score cutoff of 1.82 predicted 1-year MACE, with a sensitivity of 61.2% and a specificity of 76.2%. Conclusion: ACEF-II score, which is easy to calculate, could be used to predict 1-year MACE in patients with NSTEMI-ACS.https://thij.kglmeridian.com/downloadpdf/view/journals/thij/51/2/article-e238310.pdfangina, unstablemajor adverse cardiac eventsnon-st elevated myocardial infarctionoutcome assessmentprognosis |
| spellingShingle | Burak Ayça, MD Yasin Yüksel, MD Cennet Yildiz, MD Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina Texas Heart Institute Journal angina, unstable major adverse cardiac events non-st elevated myocardial infarction outcome assessment prognosis |
| title | Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina |
| title_full | Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina |
| title_fullStr | Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina |
| title_full_unstemmed | Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina |
| title_short | Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina |
| title_sort | value of acef ii score in predicting major adverse cardiac events in patients with non st segment elevation myocardial infarction and unstable angina |
| topic | angina, unstable major adverse cardiac events non-st elevated myocardial infarction outcome assessment prognosis |
| url | https://thij.kglmeridian.com/downloadpdf/view/journals/thij/51/2/article-e238310.pdf |
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