Survival of Patients after ST-Elevation Myocardial Infarction: External Validation of a Predictive Biomarker Model

To the Editor:Early risk stratification has the potential to play an important role in ST-elevation myocardial infarction (STEMI)1 patients who are to be treated with primary percutaneous coronary intervention (PCI). Several risk scores have been developed for STEMI patients; however, most risk scores require many variables, making them more difficult to use in clinical practice. The long-term prognostic value of biomarker measurements for glucose, N-terminal pro–brain type natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate (eGFR) taken early after admission has recently been demonstrated for STEMI patients (1). Damman and coworkers have shown that a multimarker model including these biomarkers improved the prediction of mortality over that provided by established risk factors derived from the Thrombolysis In Myocardial Infarction (TIMI) score, which include age, body mass index, diabetes, hypertension, systolic blood pressure, heart rate, anterior myocardial infarction, and time to treatment (1, 2). Moreover, a simplified risk score developed with the 3 biomarkers identified low-, intermediate- and high-risk subgroups with respect to mortality. The best way to evaluate such a model is to perform an external validation study of the predictors in a new and independent …