Do you know the predictive score?

Mortality rate tenfold for patients with 5+ markers

Minnesota Heart Study scientists evaluating long-term risk among hospitalized heart attack patients have come up with nine simple measures of clinical status that are accurate predictors of future outcomes. In one group, the four-year death rate increased from 6% for patients with none of the markers to 61% for those with five or more. The risk markers include:

previous myocardial infarction;

previous stroke;

previous cardiac arrest;

previous bypass surgery;

previous hypertension;

use of digitalis at admission;

X-ray findings of pulmonary congestion or cardiomegaly;

auscultatory findings of rales/third heart sound;

transport to the emergency department in an ambulance.

David R. Jacobs Jr., MD, a researcher at the University of Minnesota in Minneapolis, presented a poster at the American Heart Association's 38th Annual Conference on Cardiovascular Disease Epidemiology and Prevention in March in Santa Fe, NM. He said, "The risk markers are simple, observable things. They don't tell you how to treat the patient, but tell you the risk of death within four years between 10% and 80+%."

Using the nine indicators, physicians can, without complicated testing, get a quantitative, long-term view across a wide range of people and determine who is at risk, assuming aggressive care.

They can then inform the patient realistically what's likely to happen. In addition, epidemiologists can use this precise estimate of the severity of the event in future research.

Since 1980, the Minnesota Heart Study has been abstracting Twin City hospital records for AMI patients as well as stroke records.