TY - JOUR
T1 - Clinical impact of estimated plasma volume status and its additive effect with the GRACE risk score on in-hospital and long-term mortality for acute myocardial infarction
AU - Kawai, Tsutomu
AU - Nakatani, Daisaku
AU - Yamada, Takahisa
AU - Sakata, Yasuhiko
AU - Hikoso, Shungo
AU - Mizuno, Hiroya
AU - Suna, Shinichiro
AU - Kitamura, Tetsuhisa
AU - Okada, Katsuki
AU - Dohi, Tomoharu
AU - Kojima, Takayuki
AU - Oeun, Bolrathanak
AU - Sunaga, Akihiro
AU - Kida, Hirota
AU - Sato, Hiroshi
AU - Hori, Masatsugu
AU - Komuro, Issei
AU - Tamaki, Shunsuke
AU - Morita, Takashi
AU - Fukunami, Masatake
AU - Sakata, Yasushi
N1 - Funding Information:
This work was supported by Grants-in-Aid for University and Society Collaboration (#19590816 and #19390215) from the Japanese Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan. The authors declare that they have no conflict of interest.
Funding Information:
This work was supported by Grants-in-Aid for University and Society Collaboration (#19590816 and #19390215) from the Japanese Ministry of Education, Culture, Sports, Science and Technology , Tokyo, Japan.
Publisher Copyright:
© 2021
PY - 2021/4
Y1 - 2021/4
N2 - Background: Estimated plasma volume status (ePVS) is a well-validated prognostic indicator in heart failure. However, it remains unclear whether ePVS has prognostic significance in patients with acute myocardial infarction (AMI). Moreover, there is no available information on its additive effect with the Global Registry of Acute Coronary Events (GRACE) risk score in AMI patients. Methods: Data were obtained from the Osaka Acute Coronary Insufficiency Study (OACIS) registry database. Patients whose data were available for ePVS derived from Hakim's formula and the GRACE risk score were studied. The primary endpoints were in-hospital and 5-year mortality. Results: Of 3930 patients, 206 and 200 patients died during hospitalization and 5 years after discharge, respectively. After adjustment, ePVS remained an independent predictor of in-hospital death (OR:1.02, 95% CI: 1.00–1.04, p = 0.036), and 5-year mortality(HR:1.03, 95% CI: 1.01–1.04, p < 0.001). An additive effect of ePVS with the GRACE risk score was observed in predicting the 5-year mortality with an area under the receiver operating characteristic curve (AUC) from 0.744 to 0.763 (p = 0.026), but not in-hospital mortality (the AUC changed from 0.875 to 0.875, p = 0.529). The incremental predictive value of combining ePVS and the GRACE risk score for 5-year mortality was significantly improved, as shown by the net reclassification improvement (NRI:0.378, p < 0.001) and integrated discrimination improvement (IDI:0.014, p < 0.001). Conclusions: In patients with AMI, ePVS independently predicted in-hospital and long-term mortality. In addition, ePVS had an additive effect with the GRACE risk score on long-term mortality. Therefore, ePVS may be useful for identifying high-risk subjects for intensive treatment.
AB - Background: Estimated plasma volume status (ePVS) is a well-validated prognostic indicator in heart failure. However, it remains unclear whether ePVS has prognostic significance in patients with acute myocardial infarction (AMI). Moreover, there is no available information on its additive effect with the Global Registry of Acute Coronary Events (GRACE) risk score in AMI patients. Methods: Data were obtained from the Osaka Acute Coronary Insufficiency Study (OACIS) registry database. Patients whose data were available for ePVS derived from Hakim's formula and the GRACE risk score were studied. The primary endpoints were in-hospital and 5-year mortality. Results: Of 3930 patients, 206 and 200 patients died during hospitalization and 5 years after discharge, respectively. After adjustment, ePVS remained an independent predictor of in-hospital death (OR:1.02, 95% CI: 1.00–1.04, p = 0.036), and 5-year mortality(HR:1.03, 95% CI: 1.01–1.04, p < 0.001). An additive effect of ePVS with the GRACE risk score was observed in predicting the 5-year mortality with an area under the receiver operating characteristic curve (AUC) from 0.744 to 0.763 (p = 0.026), but not in-hospital mortality (the AUC changed from 0.875 to 0.875, p = 0.529). The incremental predictive value of combining ePVS and the GRACE risk score for 5-year mortality was significantly improved, as shown by the net reclassification improvement (NRI:0.378, p < 0.001) and integrated discrimination improvement (IDI:0.014, p < 0.001). Conclusions: In patients with AMI, ePVS independently predicted in-hospital and long-term mortality. In addition, ePVS had an additive effect with the GRACE risk score on long-term mortality. Therefore, ePVS may be useful for identifying high-risk subjects for intensive treatment.
KW - Acute myocardial infarction
KW - Plasma volume
KW - Prognosis
KW - The GRACE risk score
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U2 - 10.1016/j.ijcha.2021.100748
DO - 10.1016/j.ijcha.2021.100748
M3 - Article
AN - SCOPUS:85102321570
VL - 33
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
SN - 2352-9067
M1 - 100748
ER -