Prediction of 30-day mortality in older patients with a first acute myocardial infarction

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dc.contributor.author Lenderink, Timo spa
dc.contributor.author Hernández, Adrián spa
dc.contributor.author Boersma, Eric spa
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel spa
dc.contributor.author Juárez, Míriam spa
dc.contributor.author Sánchez, Pedro L. spa
dc.contributor.author Vidán, María Teresa spa
dc.contributor.author Simoons, Maarten L. spa
dc.contributor.author Fernández-Avilés, Francisco spa
dc.contributor.author Bueno, Héctor spa
dc.date.accessioned 2013-11-27T17:26:13Z
dc.date.available 2013-11-27T17:26:13Z
dc.date.issued 2010 spa
dc.identifier.citation Lenderink, T., Hernández, A., Boersma, E., Martínez-Sellés, M., Juárez, M., Sánchez, P. L., …, & Bueno, H. (2009). Prediction of 30-day mortality in older patients with a first acute myocardial infarction. Cardiology, 115(1), 1-9. spa
dc.identifier.issn 14219751 spa
dc.identifier.uri http://hdl.handle.net/11268/541
dc.description.abstract This study sought predictors of mortality in patients aged >or=75 years with a first ST-segment elevation myocardial infarction (STEMI) and evaluated the validity of the GUSTO-I and TIMI risk models. Clinical variables, treatment and mortality data from 433 consecutive patients were collected. Univariable and multivariable logistic regression analyses were applied to identify baseline factors associated with 30-day mortality. Subsequently a model predicting 30-day mortality was created and compared with the performance of the GUSTO-I and TIMI models. After adjustment, a higher Killip class was the most important predictor (OR 16.1; 95% CI 5.7-45.6). Elevated heart rate, longer time delay to admission, hyperglycemia and older age were also associated with increased risk. Patients with hypercholesterolemia had a significantly lower risk (OR 0.46; 95% CI 0.24-0.86). Discrimination (c-statistic 0.79, 95% CI 0.75-0.84) and calibration (Hosmer-Lemeshow 6, p = 0.5) of our model were good. The GUSTO-I and TIMI risk scores produced adequate discrimination within our dataset (c-statistic 0.76, 95% CI 0.71-0.81, and c-statistic 0.77, 95% CI 0.72-0.82, respectively), but calibration was not satisfactory (HL 21.8, p = 0.005 for GUSTO-I, and HL 20.6, p = 0.008 for TIMI). In conclusion, short-term mortality in elderly patients with a first STEMI depends most importantly on initial clinical and hemodynamic status. The GUSTO-I and TIMI models are insufficiently adequate for providing an exact estimate of 30-day mortality risk. spa
dc.language.iso eng spa
dc.subject.other Models, Theoretical* spa
dc.subject.other Myocardial Infarction/*Mortality spa
dc.subject.other Female spa
dc.subject.other Humans spa
dc.subject.other Male spa
dc.subject.other Risk spa
dc.subject.other Spain/Epidemiology spa
dc.title Prediction of 30-day mortality in older patients with a first acute myocardial infarction spa
dc.type article spa
dc.description.impact 1.982 JCR (2010) Q3, 58/114 Cardiac & cardiovascular systems spa
dc.identifier.doi 10.1159/000243770 spa
dc.rights.accessRights closedAccess en
dc.subject.unesco Enfermedad cardiovascular spa
dc.peerreviewed Si spa

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