Combined Value of Left Ventricular Ejection Fraction and HAS-BLED Score for Predicting Mortality in Patients with St-Elevation Myocardial Infarction Who Were Undergoing Primary Percutaneous Coronary Intervention

Objective: the has-bled score and left ventricular ejection fraction(lvef) can both independently predict clinical outcomes in patients having acute coronary syndromes. we studied the predictive value of lvef as well as has-bled score for mortality in st segment elevation myocardial infarction (stemi) patients undergoing primary percutenous coronary intervention (ppci). material-method: we investigated 588 sequential stemi patient undergoing ppci. for each patients, has-bled scores were calculated and the stipulated ability for mortality was analysed by means of area under curve (auc). the patients were considered in four different groups in terms of the their has-bled score. their groups of has-bled score were very/low risk═ 0, low risk═ 1, moderate risk═ 2, high risk ≥ 3. primary endpoint was total mortality. results: by multivariate cox regression analysis, has-bled score (p < 0.001) and lvef(p < 0.001) were independent predictors of total mortality. when has-bled score was used singly, auc for total mortality was 0.71 [95%ci═ 0.66- 0.76 ]. the auc for total mortality increased to 0.77 ( p < 0.001) after adding lvef. the incremental predictive value of combining lvef and has-bled score was significantly improved, also shown by the the net reclassification improvement (nri = 27.2%, p < 0.001) and integrated discrimination improvement (idi = 0.061, p < 0.001). conclusions: adding lvef to has-bled score independently improved the estimated value for all mortality in stemi patients undergoing ppci.