Canadian Acute Coronary Syndrome (C-ACS) Scores in Assessing Risk of Death during Treatment in Acute Myocardial Infarction Patients at Haji Adam Malik Medan General Hospital

Authors : AbdillahLubis; T. Bob Haykal; Zulfikri Mukhtar; Ali NafiahNasution; Abdul Halim Raynaldo; Harris Hasan

Volume/Issue : Volume 7 - 2022, Issue 1 - January

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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.


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30 - June - 2023

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