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Usefulness of quantitative versus qualitative ST-segment depression for risk stratification of non-ST elevation acute coronary syndromes in contemporary clinical practice.
Am J Cardiol. 2008 Apr 01; 101(7):919-24.AJ

Abstract

This aim of this study was to assess the clinical utility of quantitative ST-segment depression (STD) for refining the risk stratification of non-ST elevation acute coronary syndromes in the prospective, multinational Global Registry of Acute Coronary Events (GRACE). Quantitative measurements of STD on admission electrocardiograms were evaluated independently by a core laboratory, and their predictive value for in-hospital and cumulative 6-month mortality was examined. Although more severe STD is a marker of increased short- and long-term mortality, it is also associated with higher risk clinical features and biomarkers. Thus, after adjustment for these clinically important predictors, quantitative STD does not provide incremental prognostic value beyond simple dichotomous evaluation for the presence of STD. Furthermore, adopting quantitative instead of the prognostically proven qualitative evaluation of STD does not improve risk discrimination afforded by the validated GRACE risk models. In conclusion, the findings do not support the quantification of STD in routine clinical practice beyond simple evaluation for the presence of STD as an integral part of comprehensive risk stratification using the GRACE risk score.

Authors+Show Affiliations

Canadian Heart Research Centre and Terrence Donnelly Heart Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18359308

Citation

Yan, Raymond T., et al. "Usefulness of Quantitative Versus Qualitative ST-segment Depression for Risk Stratification of non-ST Elevation Acute Coronary Syndromes in Contemporary Clinical Practice." The American Journal of Cardiology, vol. 101, no. 7, 2008, pp. 919-24.
Yan RT, Yan AT, Granger CB, et al. Usefulness of quantitative versus qualitative ST-segment depression for risk stratification of non-ST elevation acute coronary syndromes in contemporary clinical practice. Am J Cardiol. 2008;101(7):919-24.
Yan, R. T., Yan, A. T., Granger, C. B., Lopez-Sendon, J., Brieger, D., Kennelly, B., Budaj, A., Steg, P. G., Georgescu, A. A., Hassan, Q., & Goodman, S. G. (2008). Usefulness of quantitative versus qualitative ST-segment depression for risk stratification of non-ST elevation acute coronary syndromes in contemporary clinical practice. The American Journal of Cardiology, 101(7), 919-24. https://doi.org/10.1016/j.amjcard.2007.11.041
Yan RT, et al. Usefulness of Quantitative Versus Qualitative ST-segment Depression for Risk Stratification of non-ST Elevation Acute Coronary Syndromes in Contemporary Clinical Practice. Am J Cardiol. 2008 Apr 1;101(7):919-24. PubMed PMID: 18359308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of quantitative versus qualitative ST-segment depression for risk stratification of non-ST elevation acute coronary syndromes in contemporary clinical practice. AU - Yan,Raymond T, AU - Yan,Andrew T, AU - Granger,Christopher B, AU - Lopez-Sendon,Jose, AU - Brieger,David, AU - Kennelly,Brian, AU - Budaj,Andrzej, AU - Steg,Ph Gabriel, AU - Georgescu,Alina A, AU - Hassan,Quamrul, AU - Goodman,Shaun G, AU - ,, Y1 - 2008/02/15/ PY - 2007/09/05/received PY - 2007/11/07/revised PY - 2007/11/13/accepted PY - 2008/3/25/pubmed PY - 2008/5/16/medline PY - 2008/3/25/entrez SP - 919 EP - 24 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 101 IS - 7 N2 - This aim of this study was to assess the clinical utility of quantitative ST-segment depression (STD) for refining the risk stratification of non-ST elevation acute coronary syndromes in the prospective, multinational Global Registry of Acute Coronary Events (GRACE). Quantitative measurements of STD on admission electrocardiograms were evaluated independently by a core laboratory, and their predictive value for in-hospital and cumulative 6-month mortality was examined. Although more severe STD is a marker of increased short- and long-term mortality, it is also associated with higher risk clinical features and biomarkers. Thus, after adjustment for these clinically important predictors, quantitative STD does not provide incremental prognostic value beyond simple dichotomous evaluation for the presence of STD. Furthermore, adopting quantitative instead of the prognostically proven qualitative evaluation of STD does not improve risk discrimination afforded by the validated GRACE risk models. In conclusion, the findings do not support the quantification of STD in routine clinical practice beyond simple evaluation for the presence of STD as an integral part of comprehensive risk stratification using the GRACE risk score. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18359308/Usefulness_of_quantitative_versus_qualitative_ST_segment_depression_for_risk_stratification_of_non_ST_elevation_acute_coronary_syndromes_in_contemporary_clinical_practice_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)02322-3 DB - PRIME DP - Unbound Medicine ER -