7-Day Risk Prediction for Major Adverse Cardiac Events in Acute Coronary Syndrome Patients

Background: Major Adverse Cardiac Events (MACE) increase illness and death rate among patients with acute coronary syndrome (ACS). Prediction scores have been utilized as prognostic to predict MACE. This study aims to develop a simple risk score that is easy to calculate and applicable for identifying ACS patients at risk for MACE. Methods: A retrospective cohort study involving 1,002 ACS patients in an intensive coronary care unit from January 1 ^st , 2021, until July 31 ^st , 2024. Sex, age, family history, diabetes, hemoglobin, leukocyte, creatinine, uric acid, cardiac enzyme, systolic blood pressure, heart rate, cardiac arrest, ST segment deviation, and Killip class were assessed as risk factors for MACE. Results: MACE was found in 112 (9.21%) of ACS patients. Predictors such as female, leukocyte, creatinine, uric acid, cardiac enzyme, systolic blood pressure, heart rate, cardiac arrest, and Killip class in multivariate logistic regression analysis were associated with MACE with (RR 95% CI) 2.66 (1.35-5.25), 2.06 (1.02-4.16), 2.84 (1.43-5.66), 3.79 (1.90-7.54), 3.26 (1.51-7.05), 3.48 (1.57-7.70), 2.46 (1.20-5.01), 42.04 (18.90-93.51), and 6.31 (3.19-12.50), respectively. The best predictive accuracy was obtained by an area under the curve of 0.95, 95% CI, 0.93-0.97. Conclusions: In ACS patients, the probability of MACE was found to be 3.6% for those with scores 0-6 and 83.5% for those with scores greater than 6, based on the following predictor factors: female (score 1), leukocytosis (score 1), elevated creatinine (score 1), hyperuricemia (score 2), elevated cardiac enzyme (score 1), hypotension (score 2), tachycardia (score 1), cardiac arrest (score 5), and Killip class III-IV (score 3).