INTRODUCTION Mortality from acute myocardial infarction (AMI) remains substantial. The current study is aimed at developing a novel simple risk score for AMI. METHODS The Coronary Artery Tree description and Lesion EvaluaTion (CatLet) extended validation trial (ChiCTR2000033730) and the CatLet validation trial (ChiCTR-POC-17013536), both being registered with chictr.org, served as the derivation and validation datasets, respectively. Both datasets included 1018 and 308 patients, respectively. They all suffered from AMI and underwent percutaneous intervention (PCI). The endpoint was 4-year all-cause death. Lasso regression analysis was used for covariate selection and coefficient estimation. RESULTS Of 26 candidate predictor variables, four strongest predictors for 4-year mortality were included in this novel risk score with an acronym of BACEF (serum alBumin, Age, serum Creatinine, and LVEF). This score was well calibrated and yielded an AUC (95%CI) statistics of 0.84(0.80-0.87) in internal validation, 0.89(0.83-0.95) in internal-external (temporal) validation, and 0.83(0.77-0.89) in external validation. Notably, it outperformed the ACEF, ACEFII, GRACE scores with respect to 4-year mortality prediction. CONCLUSION A simple risk score for 4-year mortality risk stratification was developed, extensively validated, and calibrated in patients with AMI. This novel BACEF score may be a useful risk stratification tool for patients with AMI.

中文翻译：

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制定并验证急性心肌梗死患者的简单风险评分。

引言 急性心肌梗死 (AMI) 的死亡率仍然很高。目前的研究旨在开发一种新颖的简单的 AMI 风险评分。方法 冠状动脉树描述和病变评估 (CatLet) 扩展验证试验 (ChiCTR2000033730) 和 CatLet 验证试验 (ChiCTR-POC-17013536) 均已在 chitr.org 注册，分别作为推导和验证数据集。两个数据集分别包含 1018 名和 308 名患者。他们都患有 AMI 并接受了经皮介入治疗 (PCI)。终点是 4 年全因死亡。Lasso 回归分析用于协变量选择和系数估计。结果 在 26 个候选预测变量中，4 个最强的 4 年死亡率预测变量包含在这个新的风险评分中，缩写为 BACEF（血清白蛋白、年龄、血清肌酐和 LVEF）。该分数经过良好校准，内部验证中的 AUC (95%CI) 统计数据为 0.84(0.80-0.87)，内部-外部（时间）验证中的 AUC (95%CI) 统计数据为 0.89(0.83-0.95)，外部验证中的 AUC (95%CI) 统计数据为 0.83(0.77-0.89)验证。值得注意的是，它在 4 年死亡率预测方面优于 ACEF、ACEFII、GRACE 评分。结论 制定了 4 年死亡率风险分层的简单风险评分，并在 AMI 患者中进行了广泛验证和校准。这种新颖的 BACEF 评分对于 AMI 患者可能是一个有用的风险分层工具。