Description

The National Registry of Myocardial Infarction (NRMI) developed a model for mortality in patients with non-ST elevation myocardial infarction. This can help identify patients who may benefit from more aggressive management.


Parameters:

(1) age and gender

(2) admission diagnosis unstable angina

(3) ST-segment depression on admission

(4) systolic blood pressure and heart rate

(5) Killip class for heart failure

(6) past medical history (7 items)

 

Parameter

Finding

Points

age and gender

>= 65 years

3

 

female and < 65 years

1

 

male and < 65 years

0

admission diagnosis unstable angina

no

2

 

yes

0

ST segment depression on admission

no

0

 

yes

1

systolic blood pressure and heart rate

systolic blood pressure < 120 mm Hg or heart rate > 100 beats per minute

2

 

systolic blood pressure >= 120 mm Hg and heart rate <= 100 beats per minute

0

Killip class

I (no heart failure)

0

 

II, III or IV

1

history of renal insufficiency

no

0

 

yes

1

history of congestive heart failure

no

0

 

yes

1

history of chronic lung disease

no

0

 

yes

1

history of hypercholesterolemia

no

1

 

yes

0

history of hypertension

no

1

 

yes

0

history of current smoking

no

1

 

yes

0

history of previous percutaneous intervention

no

1

 

yes

0

 

where:

• In the table from Peterson et al the age factor is misprinted as "> 65 years".

• For description of Killip class see 06.08.12

 

total risk score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 16

• The higher the score the greater the mortality rate.

 

Risk Score

Mortality Rate

0 to 6

2%

7

6%

8

8%

9

12%

10

15%

11

20%

>= 12

24%

from Dong et al (2001)

 

Risk Score

Mortality Rate With Early Use GP IIb/IIIa Inhibitor

Mortality Rate Without Early Use GP IIb/IIIa Inhibitor

0 to 5

0.5%

1.5%

6

1.6%

2.5%

7

1.8%

3.8%

8

3.6%

6.5%

9

4.8%

9%

10

9%

12%

>= 11

16%

18.8%

from Peterson et al (2003), Figure 1 page 49


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