Risk Score Predicts Post-MI MACE

Intermountain Major Adverse Cardiovascular Events (IMACE) risk scores can aid in predicting the risk of major adverse cardiovascular events (MACE) 1 to 3 years after an initial myocardial infarction (MI), according to a recent study.

For their study, the researchers assessed patients aged 65 years and older who survived at least 1 year after an index MI and demonstrated at least 1 risk factor for recurrent MI.
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One-year to 3-year MACE risk following an initial MI was calculated using Cox regression-derived, sex-specific IMACE scores, with derivation performed in 70% of patients (n = 1342 women, 3047 men) and validation performed in the remaining 30% (n = 576 women, 1290 men).

Findings showed that factors such as glucose, creatinine, hemoglobin, platelet count, red cell distribution width (RDW), age, and B-type natriuretic peptide (BNP) predicted CV events in women. In men, potassium, glucose, blood urea nitrogen, hematocrit, white blood cell count, RDW, mean platelet volume, age, and BNP were identified as predictors of CV events.

IMACE scores of at least 5 in women and at least 6 in men were associated with a significantly higher risk of MACE compared with lower scores.

“Sex-specific risk scores strongly stratified 1-year to 3-year post-MI MACE risk,” the researchers concluded. “IMACE is an inexpensive, dynamic, electronically delivered tool for evaluating and better managing post-MI patient care.”

—Christina Vogt

Reference:

Horne BD, Muhlestein JB, Bhandary D, et al. Clinically feasible stratification of 1-year to 3-year post-myocardial infarction risk [Published online February 20, 2018]. Open Heart. doi: 10.1136/openhrt-2017-000723.