Abstract
This article presents an overview of contemporary risk assessment systems used in patients with myocardial infarction. The full range of risk scales, both recommended by the European Society of Cardiology and others published in recent years, is presented. Scales for assessing the risk of ischemia/death as well as for assessing the risk of bleeding are presented. A separate section is devoted to systems assessing the integrated risk associated with both ischemia and bleeding. In the first part of the work, each of the risk scales is described in detail, including the clinical trials/registers on the basis of which they were created, the statistical methods used to develop them, as well as the specification of their individual parameters. The next chapter presents the practical application of a given scale in the patient risk assessment process, the timing of its application on the timeline of myocardial infarction, as well as a critical assessment of its potential advantages and limitations. The last part of the work is devoted to the presentation of potential directions for the development of risk assessment systems in the future.
Highlights
The 21st century is a time of tremendous development of medicine, and a period of implementing newer pharmacological and technological solutions into treatment
These systems were developed by using general measures of severity of illness, such as the Acute Physiology and Chronic Health [16], whereas others were based on expert opinion and prior investigation [14]
Assessed endpoint: risk of ischemia/death or bleeding risk or risk of a composite endpoint, time perspective of the risk assessment: short-term assessment of the risk or long-term assessment of risk, spectrum of analyzed ASCs: assessment of the risk in patients with STelevation myocardial infarction (STEMI) or NSTEMI/UA or patients with the full spectrum of acute coronary syndrome (ACS), the moment at which the risk analysis is performed: assessment based on the basic clinical and laboratory parameters collected on admission to the hospital or risk assessment based on the analysis of other data obtained during hospitalization or performed at the end of hospitalization, 5
Summary
The 21st century is a time of tremendous development of medicine, and a period of implementing newer pharmacological and technological solutions into treatment. Miniaturization and advances in electronics and technology have allowed the use of interventional treatment methods in modern medicine on an unprecedented scale. The process of treating this disease has gone from the use of simple drugs and the obligatory several-day bed regimen, through targeted fibrinolytic drugs, to modern, highly technologically developed methods of interventional cardiology allowing the patient to leave the hospital after a few days [1]. The simultaneous rapid development of cardiology and technology resulted in the creation of special logistic systems creating a network of medical units focused on optimizing the treatment process of patients with MI [2]. All the above-mentioned achievements make the modern methods and results of treating patients with MI radically different from those used and achieved at the beginning of the
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