Evidence map›Paper›PMID 30628957›Full record

ArticleChinese medical journal2019

Biomarkers enhance the long-term predictive ability of the KAMIR risk score in Chinese patients with ST-elevation myocardial infarction.

Jian-Jun Wang, Yan Fan, Yan Zhu, Jian-Dong Zhang, Su-Mei Zhang, Zhao-Fei Wan, Hong-Ling Su, Na Jiang

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Article in Chinese medical journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

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5citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jian-Jun WangDepartment of Orthopaedics, The First People's Hospital of Lanzhou, Lanzhou, Gansu 730050, China.
Yan FanDepartment of Cardiovascular Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China.
Yan ZhuDepartment of Cardiovascular Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China.
Jian-Dong ZhangDepartment of Orthopaedics, The First People's Hospital of Lanzhou, Lanzhou, Gansu 730050, China.
Su-Mei ZhangDepartment of Nursing, Xi'an Medical University, Xi'an, Shaanxi 710021, China.
Zhao-Fei WanDepartment of Cardiovascular Medicine, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi 710061, China.
Hong-Ling SuDepartment of Cardiovascular Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China.
Na JiangDepartment of Cardiovascular Medicine, Gansu Provincial Hospital, Lanzhou, Gansu 730000, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Global Registry of Acute Coronary Events (GRACE) score is recommended by current ST-elevation myocardial infarction (STEMI) guidelines. But it has inherent defects. The present study aimed to investigate the more compatible risk stratification for Chinese patients with STEMI and to determine whether the addition of biomarkers to the Korea Acute Myocardial Infarction Registry (KAMIR) score could enhance its predictive value for long-term outcomes.

methodsA total of 1093 consecutive STEMI patients were included and followed up 48.2 months. Homocysteine, hypersensitive C-reactive protein (hs-CRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected. The KAMIR score and the GRACE score were calculated. The performance between the KAMIR and the GRACE was compared. The predictive power of the KAMIR alone and combined with biomarkers were assessed by the receiver-operating characteristic (ROC) curve.

resultsThe KAMIR demonstrated a better risk stratification and predictive ability than the GRACE (death: AUC = 0.802 vs. 0.721, P < 0.001; major adverse cardiovascular events (MACE): AUC = 0.683 vs. 0.656, P < 0.001). It showed that the biomarkers could independently predict death [homocysteine: HR = 1.019 (1.015-1.024), P < 0.001; hs-CRP: HR = 1.052 (1.000-1.104), P = 0.018; NT-pro BNP: HR = 1.142 (1.004-1.280), P = 0.021] and MACE [homocysteine: HR = 1.019 (1.015-1.024), P < 0.001; hs-CRP: HR = 1.012 (1.003-1.021), P = 0.020; NT-pro BNP: HR = 1.136 (1.104-1.168), P = 0.006]. When they were used in combination with the KAMIR, the area under the ROC curve (AUC) significantly increased for death [homocysteine: AUC = 0.802 vs. 0.890, Z = 5.982, P < 0.001; hs-CRP: AUC = 0.802 vs. 0.873, Z = 3.721, P < 0.001; NT-pro BNP: AUC = 0.802 vs. 0.871, Z = 2.187, P = 0.047; homocysteine, hs-CRP and NT-pro BNP: AUC = 0.802 vs. 0.940, Z = 6.177, P < 0.001] and MACE [homocysteine: AUC = 0.683 vs. 0.771, Z = 6.818, P < 0.001; hs-CRP: AUC = 0.683 vs. 0.712, Z = 2.022, P = 0.031; NT-pro BNP: AUC = 0.683 vs. 0.720, Z = 2.974, P = 0.003; homocysteine, hs-CRP and NT-pro BNP: AUC = 0.683 vs. 0.789, Z = 6.900, P < 0.001].

conclusionThe KAMIR is better than the GRACE in risk stratification and prognosis prediction in Chinese STEMI patients. A combination of above-mentioned biomarkers can develop a more predominant prediction for long-term outcomes.

Indexed as

BiomarkersC-Reactive ProteinHumansMyocardial InfarctionNatriuretic Peptide, BrainPeptide FragmentsRegistriesRisk FactorsROC CurveST Elevation Myocardial InfarctionBiomarkersC-Reactive ProteinNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)

Identifiers

PMID30628957
PMCPMC6629309

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.