Table 1.5. Risk stratification for death or infarction in patients with acute ischemic syndrome without ST-segment elevation91.
| High | Moderate | Low | |
|---|---|---|---|
| Prognostic Variable | At least one of the following characteristics must be present | No high-risk features, but any of the following | No intermediate or high risk characteristics, but any of the following |
| History | Symptom worsening in the last 48 hours. Age > 75 years | Age = 70 to 75 years,previous infarction, cerebrovascular or peripheral disease, DM, revascularization surgery, previous ASA therapy | |
| Precordial pain | Prolonged pain (> 20 min), at rest. | Resting angina > 20 min resolved, with a moderate-to-high probability of CAD Angina at rest ≤20 min, with spontaneous relief or through nitrates | New episode of CCS class III or IV angina in the last 2 weeks without prolonged pain at rest, but with moderate or high probability of CAD |
| Physical exam | Pulmonary edema, worsening or appearance of mitral murmur or regurgitation, S3, new rales, hypotension, bradycardia or tachycardia | ||
| Electrocardiogram | ST-segment depression > 0.5 mm (associated or not with angina), dynamic ST change, new or presumably new complete branch block, sustained ventricular tachycardia | T-wave inversion > 2 mm; pathological Q waves. | Normal or unchanged during the pain episode |
| Serum markers of ischemia* | Markedly high | High | Normal |
*
High cardiac troponin I, cardiac troponin T, or creatine kinase-MB (preferentially mass): above the 99th percentile; slight elevation: above the detection level and below the 99th percentile. ASA: acetylsalicylic acid; CAD: coronary artery disease; CCS: Canadian Cardiovascular Society.