+44-1518081136PRESTO SCORE: SIMPLE SCORE FOR EARLY DISCHARGE OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS CORONARY ANGIOPLASTY
3rd World Congress on CARDIOLOGY AND CARDIAC NURSING
March 25-26, 2019 | Amsterdam, Netherlands
Alejandro Avila Carrillo
University clinical hospital of santiago, Spain
Scientific Tracks Abstracts : J Cardiovasc Med Ther
Abstract:
Background: Early Discharge (ED) for low-risk patients treated with primary coronary angioplasty is safe and
cost-effective. Scoring systems for ED are sophisticated and time-consuming for daily use.
Methods: We developed a score to identify low-risk patients suitables for ED; 10 points was the cutoff. Sensibility
and specificity was calculated. A survival analysis was performed comparing the results versus the GRACE score.
Results: Based on the PRESTO score we classified 1723 patients, 43.23% were in the low-risk group (<10) getting
a less cumulative incidence of major adverse cardiovascular events (MACE) and all-cause death than patients
with high-risk (≥10). The estimated hazard ratio for MACE was (HR) 11, 73 (95% confidence interval [95% CI]
3.64-37.77, p = <0.001) and for all-cause death HR 36, 77 (95% CI 5.07-266.67, p = <0.001) in the low-risk group
at 7 days of follow-up. PRESTO score got a sensitivity (SE) of 90.2% and a specificity (SP) of 45.9% for predicting
MACE with an area under ROC curve (AUC) of 0.68. The AUC for predicting all-cause death was 0.71 (SE of 98.0%
and SP of 45.7%). There were significant differences in favor to our score for predicting all-cause death (p = 0.005
to 7 days, p = <0.001 to 30 days, p = <0.001 to 90 days) and without difference for predicting MACE.
Conclusions: The PRESTO score is a simple and accurate tool for identifying low-risk patients for early discharge
after primary angioplasty, with a better prediction of all-cause death compared to the GRACE score.
Biography:
Alejandro Avila Carrillo completed his medical degree at the age of 24 years from University of Guadalajara, Mexico. After he completed his cardiology fellowship at Hospital de Especialidades “Antonio Fraga Mouret”, Mexico City, then completed his interventional cardiology fellowship at Hospital Clínico de Santiago de Compostela, in this fellowship he performed a clinical and basic investigation, involving interventional cardiology and biomaterials in interventional cardiology, even wining a grant to develop a new material for bioabsorbible coronary stent (today ongoing), also participated in a clinical proyect of clinical 3d printing, publishing a paper at revista Española de cardiología. Today he is attending physician at cardiology staff of Hospital de Especialidades “Antonio Fraga Mouret”, Mexico City and combine this with private medical activity.
E-mail: alejandro.avila.md@gmail.com
PDF HTML