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Comparison of ischemic and bleeding risk scores in non-ST elevation acute coronary syndromes.
Acute Card Care. 2011 Jun; 13(2):68-75.AC

Abstract

OBJECTIVES

Compare the discriminatory performance of two validated ischemic risk scores and a bleeding risk score for in-hospital adverse events across the spectrum of non-ST elevation acute coronary syndromes (NSTE-ACS).

MATERIAL AND METHODS

Single center, 516 consecutive patients admitted with the diagnosis of NSTE-ACS. The following risk scores were calculated for each patient: TIMI, GRACE and CRUSADE. The following in-hospital endpoints were used: major bleeding (as defined by the CRUSADE criteria); recurrent ischemia (re-infarction or recurrent angina); and death. Discriminatory performance was measured by the c-statistic and compared.

RESULTS

There were 36 major bleeding events, 34 recurrent ischemic events and 10 deaths. TIMI RS, GRACE RS, and CRUSADE RS demonstrated fair discriminatory accuracy for major bleeding (c-statistic = 0.64, 0.58, and 0.61, respectively). GRACE and CRUSADE risk scores demonstrated a better performance than TIMI RS for predicting in-hospital death (c-statistic = 0.92 and 0.86, respectively versus c-statistic = 0.63, P < 0.001). For the combined endpoint of in-hospital death or recurrent ischemia there was no statistically significant difference between CRUSADE RS, GRACE RS, and TIMI RS (c-statistic = 0.58, 0.57, and 0.62, respectively).

CONCLUSION

Both ischemic and bleeding risk scores are able to predict in-hospital bleeding, ischemic and fatal events.

Authors+Show Affiliations

Centro Hospitalar de Setúbal, Cardiologia, Setubal, Portugal. pmcamador@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21517669

Citation

Amador, Pedro, et al. "Comparison of Ischemic and Bleeding Risk Scores in non-ST Elevation Acute Coronary Syndromes." Acute Cardiac Care, vol. 13, no. 2, 2011, pp. 68-75.
Amador P, Santos JF, Gonçalves S, et al. Comparison of ischemic and bleeding risk scores in non-ST elevation acute coronary syndromes. Acute Card Care. 2011;13(2):68-75.
Amador, P., Santos, J. F., Gonçalves, S., Seixo, F., & Soares, L. (2011). Comparison of ischemic and bleeding risk scores in non-ST elevation acute coronary syndromes. Acute Cardiac Care, 13(2), 68-75. https://doi.org/10.3109/17482941.2011.567287
Amador P, et al. Comparison of Ischemic and Bleeding Risk Scores in non-ST Elevation Acute Coronary Syndromes. Acute Card Care. 2011;13(2):68-75. PubMed PMID: 21517669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of ischemic and bleeding risk scores in non-ST elevation acute coronary syndromes. AU - Amador,Pedro, AU - Santos,Jose Ferreira, AU - Gonçalves,Sara, AU - Seixo,Filipe, AU - Soares,Luis, Y1 - 2011/04/25/ PY - 2011/4/27/entrez PY - 2011/4/27/pubmed PY - 2011/9/29/medline SP - 68 EP - 75 JF - Acute cardiac care JO - Acute Card Care VL - 13 IS - 2 N2 - OBJECTIVES: Compare the discriminatory performance of two validated ischemic risk scores and a bleeding risk score for in-hospital adverse events across the spectrum of non-ST elevation acute coronary syndromes (NSTE-ACS). MATERIAL AND METHODS: Single center, 516 consecutive patients admitted with the diagnosis of NSTE-ACS. The following risk scores were calculated for each patient: TIMI, GRACE and CRUSADE. The following in-hospital endpoints were used: major bleeding (as defined by the CRUSADE criteria); recurrent ischemia (re-infarction or recurrent angina); and death. Discriminatory performance was measured by the c-statistic and compared. RESULTS: There were 36 major bleeding events, 34 recurrent ischemic events and 10 deaths. TIMI RS, GRACE RS, and CRUSADE RS demonstrated fair discriminatory accuracy for major bleeding (c-statistic = 0.64, 0.58, and 0.61, respectively). GRACE and CRUSADE risk scores demonstrated a better performance than TIMI RS for predicting in-hospital death (c-statistic = 0.92 and 0.86, respectively versus c-statistic = 0.63, P < 0.001). For the combined endpoint of in-hospital death or recurrent ischemia there was no statistically significant difference between CRUSADE RS, GRACE RS, and TIMI RS (c-statistic = 0.58, 0.57, and 0.62, respectively). CONCLUSION: Both ischemic and bleeding risk scores are able to predict in-hospital bleeding, ischemic and fatal events. SN - 1748-295X UR - https://www.unboundmedicine.com/medline/citation/21517669/Comparison_of_ischemic_and_bleeding_risk_scores_in_non_ST_elevation_acute_coronary_syndromes_ L2 - https://www.tandfonline.com/doi/full/10.3109/17482941.2011.567287 DB - PRIME DP - Unbound Medicine ER -