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Does acute hyperglycemia add prognostic value to the GRACE score in individuals with non-ST elevation acute coronary syndromes?
Clin Chim Acta. 2009 Dec; 410(1-2):74-8.CC

Abstract

BACKGROUND

It is not known in what extent admission glucose improves risk stratification of the GRACE Score in patients with non-ST-segment elevation acute coronary syndromes (ACS). We tested the hypothesis that admission glucose adds relevant prognostic information to the GRACE Score.

METHODS

Consecutive patients admitted with ACS had plasma glucose measured at admission and cardiovascular events were defined as death, non-fatal myocardial infarction or non-fatal refractory angina during hospitalization.

RESULTS

Among the 148 patients studied, 11.5% developed cardiovascular events. Patients in the forth quartile of admission glucose (> or =175mg/dl) had a greater incidence of events, compared with those in the first 3 quartiles (22% vs. 8.1%; RR=2.7; 95%CI 1.1-6.4; P=0.03). Plasma glucose remained a predictor of events, after adjustment for diabetes (P=0.03). After adjustment for the GRACE Score, glucose in the forth quartile lost its predictive value (P=0.29). Plasma glucose added to GRACE did not improve the C-statistics (0.82; 95%CI 0.75-0.88), as compared with the original Score (0.81; 95%CI 0.74-0.87). Net reclassification improvement by new score was -0.03 (P=0.86), indicating no useful reclassification.

CONCLUSION

Despite its association with adverse events, admission plasma glucose does not improve GRACE's accuracy to predict in-hospital events in patients with ACS.

Authors+Show Affiliations

Cardiology Division, Portuguese Hospital, Salvador/BA, Brazil. lccorreia@terra.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19804768

Citation

Correia, Luis C L., et al. "Does Acute Hyperglycemia Add Prognostic Value to the GRACE Score in Individuals With non-ST Elevation Acute Coronary Syndromes?" Clinica Chimica Acta; International Journal of Clinical Chemistry, vol. 410, no. 1-2, 2009, pp. 74-8.
Correia LC, Rocha MS, Bittencourt AP, et al. Does acute hyperglycemia add prognostic value to the GRACE score in individuals with non-ST elevation acute coronary syndromes? Clin Chim Acta. 2009;410(1-2):74-8.
Correia, L. C., Rocha, M. S., Bittencourt, A. P., Freitas, R., Souza, A. C., Almeida, M. C., & Péricles Esteves, J. (2009). Does acute hyperglycemia add prognostic value to the GRACE score in individuals with non-ST elevation acute coronary syndromes? Clinica Chimica Acta; International Journal of Clinical Chemistry, 410(1-2), 74-8. https://doi.org/10.1016/j.cca.2009.09.026
Correia LC, et al. Does Acute Hyperglycemia Add Prognostic Value to the GRACE Score in Individuals With non-ST Elevation Acute Coronary Syndromes. Clin Chim Acta. 2009;410(1-2):74-8. PubMed PMID: 19804768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does acute hyperglycemia add prognostic value to the GRACE score in individuals with non-ST elevation acute coronary syndromes? AU - Correia,Luis C L, AU - Rocha,Mário S, AU - Bittencourt,Ana P, AU - Freitas,Rafael, AU - Souza,Alexandre C, AU - Almeida,Maria C, AU - Péricles Esteves,J, Y1 - 2009/10/02/ PY - 2009/07/31/received PY - 2009/09/14/revised PY - 2009/09/21/accepted PY - 2009/10/7/entrez PY - 2009/10/7/pubmed PY - 2010/1/15/medline SP - 74 EP - 8 JF - Clinica chimica acta; international journal of clinical chemistry JO - Clin. Chim. Acta VL - 410 IS - 1-2 N2 - BACKGROUND: It is not known in what extent admission glucose improves risk stratification of the GRACE Score in patients with non-ST-segment elevation acute coronary syndromes (ACS). We tested the hypothesis that admission glucose adds relevant prognostic information to the GRACE Score. METHODS: Consecutive patients admitted with ACS had plasma glucose measured at admission and cardiovascular events were defined as death, non-fatal myocardial infarction or non-fatal refractory angina during hospitalization. RESULTS: Among the 148 patients studied, 11.5% developed cardiovascular events. Patients in the forth quartile of admission glucose (> or =175mg/dl) had a greater incidence of events, compared with those in the first 3 quartiles (22% vs. 8.1%; RR=2.7; 95%CI 1.1-6.4; P=0.03). Plasma glucose remained a predictor of events, after adjustment for diabetes (P=0.03). After adjustment for the GRACE Score, glucose in the forth quartile lost its predictive value (P=0.29). Plasma glucose added to GRACE did not improve the C-statistics (0.82; 95%CI 0.75-0.88), as compared with the original Score (0.81; 95%CI 0.74-0.87). Net reclassification improvement by new score was -0.03 (P=0.86), indicating no useful reclassification. CONCLUSION: Despite its association with adverse events, admission plasma glucose does not improve GRACE's accuracy to predict in-hospital events in patients with ACS. SN - 1873-3492 UR - https://www.unboundmedicine.com/medline/citation/19804768/Does_acute_hyperglycemia_add_prognostic_value_to_the_GRACE_score_in_individuals_with_non_ST_elevation_acute_coronary_syndromes L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-8981(09)00493-8 DB - PRIME DP - Unbound Medicine ER -