Copyright © 1998 by the European Society of Cardiology.
The Cardiac Infarction Injury Score as a predictor for long-term mortality in survivors of a myocardial infarction
a Thoraxcenter, Erasmus University, University Hospital Rotterdam, Rotterdam, The Netherlands
b ASPECT Coordinating Center, Rotterdam, The Netherlands
revised January 19, 1998; accepted January 25, 1998
Aims
The Cardiac Infarction Injury Score (CIIS) is an electrocardiographic classification system that was developed as a diagnostic tool to assess the extent of cardiac injury in acute myocardial infarction. We investigated the prognostic value of the CIIS in post-myocardial infarction patients.
Methods and Results
The prognostic values of the CIIS for total and cardiac mortality was assessed in a large series (n=3395) of patients who were enrolled in the ASPECT trial. Standard 12-lead electrocardiograms, recorded prior to hospital discharge were coded according to the CIIS and the Minnesota Code. Mean CIIS was 26 (range –8 to 59). After adjustment for other baseline characteristics, the CIIS was directly related to the risk of total mortality and cardiac mortality. At one-year follow-up the relative risks of CIIS 
40, CIIS 30–40 and CIIS 20–30 were significantly higher than in those with a CIIS <20. The relative risks were, respectively, 2·3 (1·2–4·4), 2·2 (1·3–3·9) and 1·6 (0·9–2·9). At 3 year follow-up, the relative risks were, respectively, 2·1 (1·4–3·2), 1·7 (1·2–2·4) and 1·5 (1·0–2·1). The relative risks for total mortality were similar. When patients with major ECG abnormalities, as defined by the Minnesota code, were excluded, the associations were still significant in the CIIS classes 30–40 and >40.
Conclusion
The CIIS ECG scoring system is an important predictor for long-term cardiac mortality in post myo-cardial infarction patients. It can easily be automated and is efficient for classifying cardiac injury in epidemiological studies.
Key Words: Myocardial infarction • ECG • long-term outcome • risk factor
f1 Correspondence: Ron T. van Domburg, University Hospital Rotterdam, Department of Cardiology, Bd308, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
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