eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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2/2021
vol. 17
 
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abstract:
Original paper

Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy

Altuğ Ösken
1
,
Recep Hacı
1, 2
,
Sena Sert Şekerci
1
,
Lale Dinç Asarcıklı
1
,
Gizem Yüksel
1
,
Büşra Ceylan
1
,
Şennur Ünal Dayı
1
,
Neşe Çam
1

  1. Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
  2. Department of Cardiology, Yalova State Hospital, Yalova, Turkey
Adv Interv Cardiol 2021; 17, 2 (64): 170–178
DOI: https://doi.org/10.5114/aic.2021.107495
Online publish date: 2021/07/09
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Introduction
In patients who have undergone interventional cardiac procedures, the risk of bleeding is higher than in patients who received conservative treatment due to multiple medications and comorbidities.

Aim
This study aimed to evaluate the usefulness of the age, creatinine and ejection fraction (ACEF) score for predicting bleeding events and to compare short- and long-term clinical outcomes according to the ACEF score in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) with bail-out tirofiban therapy (BOTT).

Material and methods
A total of 2,543 patients were included and divided into three groups according to the following ACEF score tertiles: T1 (ACEFlow ≤ 1.033), T2 (1.033 < ACEFmid ≤ 1.371), and T3 (ACEFhigh > 1.371). The main outcomes measured were the incidence rates of relevant bleeding events and mortality within 30 days and 3 years after the procedure.

Results
A total of 73 (2.9%) patients had Bleeding Academic Research Consortium bleeding events of grades 3, 4 or 5 and 104 (4%) patients died in a 30-day period. The ACEF score was effective at predicting 30-day bleeding (area under the receiver operating characteristic curve (AUC): 0.658, 95% confidence interval (CI): 0.579–0.737; p < 0.001), 30-day mortality (AUC = 0.701, 95% CI: 0.649–0.753; p < 0.001) and 3-year mortality (AUC = 0.778, 95% CI: 0.748–0.807; p < 0.001) events. Considering the ACEF score tertiles, T3 patients presented greater 30-day bleeding (1.6%, 2.8% and 4.1%; odds ratio (OR) = 2.56, 95% CI: 1.37–4.80), 30-day mortality (1.7%, 3.5% and 7.1%; OR = 4.53, 95% CI: 2.51–8.18) and 3-year mortality (6.4%, 11% and 19.8%; hazard ratio = 3.56, 95% CI: 2.58–4.91) risks.

Conclusions
The ACEF score is a user-friendly tool with excellent predictive value for bleeding events and mortality in patients undergoing pPCI with BOTT.

keywords:

acute ST-segment elevation myocardial infarction, ACEF score, primary percutaneous coronary intervention
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