Article ; Online: The prognostic value of MELD-XI in elderly patients with ST-segment elevation myocardial infarction: an observational study.
2021 Volume 21, Issue 1, Page(s) 53
Abstract: Background: The model for end-stage liver disease excluding international normalized ratio (MELD-XI) is a simple score for risk assessment. However, the prognostic role of MELD-XI and its additional value to current risk assessment in elderly patients ... ...
| Abstract | Background: The model for end-stage liver disease excluding international normalized ratio (MELD-XI) is a simple score for risk assessment. However, the prognostic role of MELD-XI and its additional value to current risk assessment in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is uncertain. Methods: In all, 1029 elderly patients with STEMI undergoing PCI were consecutively included and classified into three groups according to the TIMI risk score: low-risk (≤ 3, n = 251); moderate-risk (4-6, n = 509); and high-risk (≥ 7, n = 269) groups. Multivariate analysis was performed to identify risk factors for adverse events. Results: The overall in-hospital mortality was 5.3% and was significantly higher in the high-risk group (1.2% vs. 3.3% vs. 13.0%, p < 0.001). The optimal cut-off of the TIMI risk score and MELD-XI for in-hospital death was 7 and 13, respectively. MELD-XI was associated with in-hospital (adjusted odds ratio = 1.09, 95% CI = 1.04-1.14, p = 0.001) and one-year (adjusted hazard ratio = 1.05, 95% CI = 1.01-1.08, p = 0.005) mortality independently of the TIMI risk score. Combining TIMI risk score and MELD-XI exhibited better predictive power for in-hospital death than TIMI risk score (area under the curve [AUC] = 0.810 vs. 0.753, p = 0.008) or MELD-XI alone (AUC = 0.810 vs. 0.750, p = 0.018). Patients with TIMI risk score ≥ 7 and MELD-XI ≥ 13 had the worst prognosis. Conclusion: MELD-XI could be considered as a risk-stratified tool for elderly patients with STEMI undergoing PCI. It had an additive prognostic value to TIMI risk score. |
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| MeSH term(s) | Age Factors ; Aged ; Clinical Decision Rules ; Clinical Decision-Making ; End Stage Liver Disease/diagnosis ; End Stage Liver Disease/mortality ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/mortality ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/mortality ; ST Elevation Myocardial Infarction/therapy ; Severity of Illness Index ; Time Factors ; Treatment Outcome |
| Language | English |
| Publishing date | 2021-01-28 |
| Publishing country | England |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 2059859-2 |
| ISSN | 1471-2261 ; 1471-2261 |
| ISSN (online) | 1471-2261 |
| ISSN | 1471-2261 |
| DOI | 10.1186/s12872-021-01862-5 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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