Authors : AbdillahLubis; T. Bob Haykal; Zulfikri Mukhtar; Ali NafiahNasution; Abdul Halim Raynaldo; Harris Hasan
Volume/Issue : Volume 7 - 2022, Issue 1 - January
Google Scholar : http://bitly.ws/gu88
Scribd : https://bit.ly/33Ipehk
DOI : https://doi.org/10.5281/zenodo.5893830
There are several clinical scores for risk
stratification of patients with Acute Myocardial
Infarction (AMI) such as the Global Registry of Acute
Coronary Events (GRACE) score, but it is not simple to
use. The C-ACS score is a simple score that only consists
of age, Killip class, systolic blood pressure, and heart
rate that can easily and quickly predict mortality risk.
The aim of this study was to assess the predictive value
of the C-ACS score for mortality risk during
hospitalization in patients with AMI.
Method: This study is an ambispective cohort study of
112 AMI patients undergoing treatment at Adam Malik
General Hospital from July 2020 to December 2020. At
the time of admission, the C-ACS scores and GRACE
scores were calculated for each patient. The C-ACS
score variables are: age (≥75 years); Killip class >1,
systolic blood pressure <100 mmHg and heart rate >
100x/minute. Then study subjects were followed during
hospitalization to assess the incidence of mortality.
Statistical analysis was performed using the mean
difference and receiver operating curve (ROC).
Result: There were a total of 112 patients consisting of
89 IMAEST patients, 23 IMANEST patients. The mean
age of the patients was 57.25±10,36 years with a
mortality rate during hospitalization of 11.6%. Bivariate
analysis showed a significant relationship between CACS scores and mortality during hospitalization (p =
0.003) with OR value 8.65 (95% CI 2.26- 35.7). The
discriminatory performance of the C-ACS score reached
an area under curve (AUC) value of 0.816 and the
calibration performance showed a value of R2 = 0.43
with a p-value in the Hosmer Lemeshow test of 0.240.
Meanwhile, the GRACE score provides better
discrimination and calibration performance with an
AUC value of 0.914 and a calibration plot (R2
) = 0.49
with the results of the Hosmer Lemeshow test getting a p
value of 0.269.
Conclusion: The C-ACS score is asimple and useful risk
stratification for predicting the risk of mortality during
hospitalization in patients with AMI
Keywords : C-ACS score, mortality, AMI, MACE, risk stratification.