Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better.

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Abstract Text:

Andrew T Yan,Raymond T Yan,Mary Tan,Amparo Casanova,Marino Labinaz,Kumar Sridhar,David H Fitchett,Anatoly Langer,Shaun G Goodman,Andrew T Yan,Raymond T Yan,Mary Tan,Amparo Casanova,Marino Labinaz,Kumar Sridhar,David H Fitchett,Anatoly Langer,Shaun G Goodman,

AIMS: Our objectives were (i) to compare the discriminatory performance of the Thrombolysis in Myocardial Infarction risk score (TIMI RS), Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy risk score (PURSUIT RS), and Global Registry of Acute Cardiac Events risk score (GRACE RS) for in-hospital and 1 year mortality across the broad spectrum of non-ST-elevation acute coronary syndromes (ACS) and (ii) to determine their incremental prognostic utility beyond overall risk assessment by physicians. METHODS AND RESULTS: We calculated the TIMI RS, PURSUIT RS, and GRACE RS for 1,728 patients with non-ST-elevation ACS in the prospective, multicentre, Canadian ACS II Registry. Discriminatory performance was measured by the c-statistic (area under receiver-operating characteristic curve) and compared by the method described by DeLong. TIMI RS, PURSUIT RS, and GRACE RS all demonstrated good discrimination for in-hospital death (c-statistics = 0.68, 0.80, 0.81, respectively, all P < 0.001) and 1 year mortality (c-statistics = 0.69, 0.77, 0.79, respectively, all P < 0.0001). However, PURSUIT RS and GRACE RS performed significantly better than the TIMI RS in predicting in-hospital (P = 0.036 and 0.02, respectively) and 1 year (P = 0.006 and 0.001, respectively) outcomes. In multivariable analysis adjusting for the use of in-hospital revascularization, stratification by tertiles of risk scores (into low, intermediate, and high-risk groups) furnished independent and greater prognostic information compared with risk assessment by treating physicians for 1 year outcome. CONCLUSION: Compared with TIMI RS, both PURSUIT RS and GRACE RS allow better discrimination for in-hospital and 1 year mortality in patients presenting with a wide range of ACS. All three risk scores confer additional important prognostic value beyond global risk assessment by physicians. These validated risk scores may refine risk stratification, thereby improving patient care in routine clinical practice.

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Publishing Authors By Initials

AT Yan,RT Yan,M Tan,A Casanova,M Labinaz,K Sridhar,DH Fitchett,A Langer,SG Goodman,AT Yan,RT Yan,M Tan,A Casanova,M Labinaz,K Sridhar,DH Fitchett,A Langer,SG Goodman,

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Journal Published:

PUBLICATION TYPE: Multicenter Study

Journal: European heart journal

VOLUME: 28

Page Numbers: 1072-8

Journal Abbreviation:

ISSN: 0195-668X

DAY: 16

MONTH: 04

YEAR: 2007

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8006263

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better.

AFFILIATION: Canadian Heart Research Centre, Toronto, Ontario, Canada.

Country: England

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Eur Heart J

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better Related Publications

• (n-6) PUFA increase and dairy foods decrease prostate cancer risk in heavy smokers.
• Accessibility of family planning services: impact of structural and organizational factors.
• Adverse reactions to polylactic acid injections in the periorbital area.
• Application of nonlinear dynamics to human postural control system.
• Approach to the evaluation of small fiber peripheral neuropathy and disorders of orthostatic intolerance.
• Association of estrogen and progestin potency of oral contraceptives with ovarian carcinoma risk.
• Autobiographical memory and suggestibility in children with autism spectrum disorder.
• Comments on plasma parathyroid hormone levels and their relationship to bone histopathology among patients undergoing dialysis.
• Deltoid flap combined with fascia lata autograft for rotator cuff defects: a histologic study.
• Distribution of auditory and visual naming sites in nonlesional temporal lobe epilepsy patients and patients with space-occupying temporal lobe lesions.
• Does nitric oxide act in the ventromedial preoptic area to mediate oestrogen negative feedback in the seasonally anoestrous ewe?
• Effect of comorbid tics on a clinically meaningful response to 8-week open-label trial of fluoxetine in obsessive compulsive disorder.
• Effects of stress on the hemolymph juvenile hormone binding protein titers of Manduca sexta.
• Factor-analytic study of the Yale Global Tic Severity Scale.
• Florida Obsessive-Compulsive Inventory: development, reliability, and validity.
• Functionally important glycosyltransferase gain and loss during catarrhine primate emergence.
• Grading and staging systems for inflammation and fibrosis in chronic liver diseases.
• Modifying the beta,gamma leaving-group bridging oxygen alters nucleotide incorporation efficiency, fidelity, and the catalytic mechanism of DNA polymerase beta.
• Orphan nuclear receptor constitutive active/androstane receptor-mediated alterations in DNA methylation during phenobarbital promotion of liver tumorigenesis.
• Physical Activity in Adolescence: Associations with School Disconnectedness: 2605: Board #152 June 2 8:00 AM - 9:30 AM.
• Purification and characterization of Escherichia coli DNA polymerase V.
• Rashomon revisited: two views of monitoring the Women's Health Initiative trials.
• Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better.
• Social status, stress, and adolescent smoking.
• T1DBase: integration and presentation of complex data for type 1 diabetes research.
• Teaching manual communication to preservice teachers of the deaf in an accredited comprehensive undergraduate teacher preparation program.
• The CITI program: an international online resource for education in human subjects protection and the responsible conduct of research.
• The children's Yale-Brown obsessive-compulsive scale: psychometric properties of child- and parent-report formats.
• Variation in the monocyte proteome.
• Vth world congress of the international academy of cosmetic dermatology, melbourne, australia, december 9-13, 2006.