PROGNOSTIC VALUE OF THE ORIGINAL AND MODIFIED MAPH SCORE IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Highlights

• At the best of our knowledge, it is the first study confirmed the prognostic significance of the global assessment of thrombotic burden (MAPH) scale in patients with myocardial infarction with ST-segment elevation has been confirmed in domestic real clinical practice. The modification of the scale, MAPHm, is presented, which allows more accurate one assessment of the hospital mortality risk in patients with myocardial infarction with ST-segment elevation.

Aim. To evaluate the prognostic value of the new score for determining thrombus burden (MAPH) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods. The study included STEMI patients (n = 171) admitted to PCI centre. All patients were assessed for the MAPH score, an estimation of the thrombotic burden based on age, hematocrit, mean platelet volume (MPV), and total protein concentration. In the modified score (MAPHm), we replaced total protein with fibrinogen concentration. In-hospital mortality was used as the end point.

Results. Surviving patients included in the study were younger: 63 (54; 70) years vs. 70 (66; 85) years, p = 0.001, and were characterized by higher MPV (p = 0.003). Screening hematological parameters, lipid profile characteristics, prevalence of cardiac risk factors, arterial hypertension, and diabetes mellitus were comparable. Most often, the MAPH index was equal to 1 point in surviving patients (51 (33.8) %) and 2 points in deceased patients (10 (50%)). At the same time, MAPH equal to 0 did not occur among patients who reached the endpoint. 2 or more points on the MAPH scale were associated with an increased risk of death: OR 2.7 (CI 1.1; 7.2), p = 0.031. For the modified MAPHm, the OR was 6.9 (CI 2.5; 19.2), p = 0.000.

Conclusion. The new MAPH score and its modified version MAPHm can be used for risk stratification of patients with STEMI.

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