Importance of EuroSCORE-II in the Development of Acute Ischemic Heart Failure After Acute Anterior ST Elevation Myocardial Infarction
İlker Gül, Mustafa Zungur, Ahmet Çağrı Aykan, Aysel İslamlı, Bekir Serhat Yıldız, Murat Bi̇lgi̇n
Keywords: Coronary artery disease, ST elevation myocardial infarction, EuroSCORE-II, acute ischemic heart failure
Introduction: We aimed to evaluate the importance of the EuroSCORE-II (ES-II) risk-scoring system in predicting the development of acute ischemic heart failure (AIHF) after acute anterior ST segment elevation myocardial infarction (A-STEMI). Patients and Methods: A total of 261 patients (206 male; mean age, 63.5 ± 14.2 years) admitted to our centre with A-STEMI between April 2012 and January 2013 were included in the study. The patients were divided into two groups according to their clinical findings and were prospectively followed during the hospitalisation period for the development of cardiac morbidity and mortality. These groups were the AIHF group (n= 69) and non-AIHF group (n= 192). For the diagnosis of AIHF, we considered the recommendations of the European Society of Cardiology Guidelines on Heart Failure and the Framingham criteria. Results: According to our results, the morbidity and mortality rates were higher in the AIHF group. Symptom-to-balloon time, ejection fraction (EF), glomerular filtration rate (gfr), no-reflow phenomenon, left main coronary artery disease and ES-II, which are the predictors of the development of AIHF, were determined via logistic regression analysis. ROC analysis revealed that symptom-to-balloon time > 209.5 min, EF < 36.5%, gfr < 68.5 mg/dL/1.73 m2 and ES-II > 4.9% were the cut-off values in the development of AIHF. Conclusion: Patients with A-STEMI complicated by AIHF have significantly high mortality rates. With the pre-estimation of the development of AIHF, complication rates can be reduced. For this purpose, ES-II score > 4.9% can be used as a predictor of AIHF after A-STEMI.