SAVE Post-MI LV Dysfunction Prognostic Score (Proposed)
- SAVE Post-MI LV Dysfunction Prognostic Score — Explanation and Clinical Context
This calculator estimates the prognosis of patients after myocardial infarction (MI) with left ventricular (LV) systolic dysfunction, using key clinical and laboratory parameters repeatedly shown to correlate with mortality and adverse remodeling. The variables include age, LVEF, Killip class, renal function, systolic blood pressure, heart rate, infarct location, and diabetes status.
Rationale:
Lower LVEF, higher Killip class, renal dysfunction, hypotension, and tachycardia all signal more severe myocardial injury and hemodynamic compromise. Anterior infarction and diabetes further worsen prognosis due to larger infarct size and metabolic vulnerability.
Interpretation:
Scores are grouped into low, intermediate, high, and very high risk, reflecting estimated 1-year mortality probabilities. These estimates are not derived from direct cohort validation but are informed by contemporary data from post-MI LV dysfunction registries and the SAVE trial population.
Limitations:
This “SAVE” score is a proposed bedside tool. The original SAVE trial (Survival and Ventricular Enlargement) by Pfeffer et al. demonstrated the benefit of ACE inhibition post-MI in patients with LV dysfunction, but did not produce a numerical prognostic model. Therefore, this calculator provides an educational approximation rather than a validated risk prediction.
References:
Pfeffer MA, Braunwald E, Moye LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 1992;327:669–677.
Sutton MSJ, Pfeffer MA, Moye LA, et al. Cardiovascular death and left ventricular remodeling 4 years after myocardial infarction. Circulation. 1997;96:3294–3299.
Ng VG, Januzzi JL, et al. Prognostic importance of left ventricular function in heart disease: A contemporary review.
Note: Do not confuse with the ECMO-related SAVE (Survival After Veno-Arterial ECMO) score.
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