부산대학교 도서관

Introduction: Early identification of high-risk patients is the cornerstone of managing patients with ST elevation myocardial infarction (STEMI). The simple risk index (SRI), which is calculated by the formula: (HR х [age/10]2) / systolic blood pressure was shown to be able to stratify 30-day prognosis. However, prognostic impacts of prehospital SRI (Pre-SRI) in STEMI patients remain unknown.Methods: We performed retrospective analysis of 2047 STEMI patients who underwent emergency primary percutaneous coronary intervention (PCI) from January 2013 to December 2017. Pre-SRI was recorded by emergency services at the first contact with the patient before admission, and ER-SRI was recorded at emergency room. The primary end point was defined as 2 years all-cause death.Results: All-cause death was observed in 219 (11%) patients. The cut off value of Pre-SRI for predicting 2 years all cause death was 34 from ROC (AUC 0.800, P<0.001), and the cut off value of ER-SRI for predicting 2 years all cause death was also 34 from ROC analysis (AUC 0.809, P<0.001) According to the Kaplan-Meier survival analysis by combination of Pre-SRI and ER-SRI, the patients with Pre-SRI≧34 and ER-SRI≧34 showed significantly higher all-cause mortality compared to the patients with Pre-SRI≧34 and ER-SRI<34, the patients with Pre-SRI<34 and ER-SRI≧34, and the patients with Pre-SRI<34 and ER-SRI<34 (p<0.001).Conclusions: High Pre-SRI increase mortality and assessment of both high Pre-SRI and high ER-SRI enhance risk stratification in STEMI patients. Early recognizing high Pre-SRI may help us make better strategies and improve prognosis for high-risk STEMI patients.