ACEF (AGE, CREATININE, EJECTION FRACTION) SCORES AS A PREDICTOR OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION IN ADAM MALIK GENERAL HOSPITAL

Abstract

Introduction: Several clinical scores are available for risk stratification of patients with STEMI, such as TIMI Risk score and GRACE score, but all are complex to use. The ACEF score, a simple score that considers age, creatinine, and ejection fraction, was originally been developed for risk stratification of patients undergoing elective cardiac surgery and validated in patients undergoing PCI. This study aimed to assess the predictive value of the ACEF score for in-hospital MACE in patients with STEMI.

Method: This cohort ambispective study included 112 consecutive patients with STEMI from January 2020 until December 2020 admitted to Adam Malik General Hospital. The ACEF score was calculated when admission for each patient using the equation of age/ejection fraction +1 if creatinine level is >2 mg/dl. Then, subjects were observed in-hospital major cardiovascular events (MACE), which are mortality, acute heart failure, cardiogenic shock, and malignant arrhythmias. Statistical analysis was performed using mean difference and receiver operating curve (ROC).

Result: Among 112 patients, MACE were observed in 40 patient (35,7%) with the most common MACE was acute heart failure (19,6%). Bivariate analysis showed a significant relationship between ACEF score and inhospital MACE (p <0,001) with OR value of 4.96 (95% CI 4.68 – 30.7). The ACEF score AUC prediction value was 0,850 (95% CI: 0.775-0.925) with sensitivity 80% and specificity 78%.

Conclusion: The ACEF score is a simple and useful risk stratification to predict in-hospital MACE in a patient with STEMI.