![]() However, there are some limitations and unanswered questions in the study. Therefore, the authors concluded that family history might be an independent prognostic predictor in females and in a low-risk subset of patients with AMI. In a subgroup analysis, family history had negative prognostic implications for females (composite MACEs, p = 0.057) and a low-risk subset group (cardiac death, p = 0.008). Using multivariate analysis, family history was related to the risk of MACEs (hazard ratio, 1.41 p = 0.009) and cardiac death (HR, 1.56 p = 0.080). During about 1 year of clinical follow-up (median, 341 days interquartile range, 36 to 388 days), 75 patients had composite major adverse cardiac events (MACEs), resulting in 22 cardiac deaths. Male patients with a family history included more current smokers and individuals with poor lipid profiles. The patients with a family history were younger and included more male patients. In the study, 727 patients with a family history of premature CAD were compared to 12,885 controls. The registry consists of 50 community and teaching hospitals with facilities for primary PCI and on-site cardiac surgery. KAMIR, launched in November 2005, is a Korean prospective multicenter data collection registry that reflects real world treatment practices and outcomes in Asian patients presenting with AMI. A cohort of 11,612 consecutive patients (male 8,132, 62.7 ± 12.6 years old) with AMI from the Korea Acute Myocardial Infarction Registry (KAMIR) conducted during November 2005 to 2008 was analyzed. in this issue of The Korean Journal of Internal Medicine reports the impact of family history of premature CAD on clinical outcome in patients with AMI. In concert with these studies, Kim et al. These risk factors could be very useful for guiding postdischarge care such as optimal medical therapy. In particular, the GRACE 6-month postdischarge model (age, history of heart failure, history of myocardial infarction, heart rate, systolic blood pressure, ST segment depression, initial serum creatinine, elevated cardiac enzymes, no percutaneous coronary intervention ) is a robust tool for predicting long-term clinical outcomes in patients with ACS and has been demonstrated to predict mortality for up to 4 years with good accuracy. The Global Registry of Acute Coronary Events (GRACE) risk score is an alternative model that can be used to estimate in-hospital and 6-month mortal it y fol lowing acute coronar y syndrome (ACS) which may have a slightly higher predictive value than that of the TIMI score. ![]() ![]() The most widely used is the Thrombolysis in Myocardial Infarction (TIMI) risk score to predict 14- to 30-day mortality. Several risk scores have been developed over the past decade to assess short- and long-term outcomes after AMI. Risk stratif ication of patients with AMI begins upon presentation and is a continuous process to predict those who are at high risk for further ischemic events and who are at increased risk after discharge. The prognosis varies markedly according to the presence of adverse risk factors. Survivors of acute myocardial infarction (AMI) face a substantial excess risk of further cardiovascular events, including increased mortality.
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