A Risk Assessment Tool Incorporating New Biomarkers for Cardiovascular Events in Acute Coronary Syndromes: The Organization to Assess Strategies in Ischemic Syndromes (OASIS) Risk Score

Mehta, Shamir R.; Eikelboom, John W.; Rao‐Melacini, Purnima; Weitz, Jeffrey I.; Anand, Sonia S.; Paré, Guillaume; Budaj, A; Pogue, Janice; Fox, Keith A.A.; Yusuf, Salim

doi:10.1016/j.cjca.2016.01.029

Cited by 11 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some new biomarkers have showed improved GRACE risk score prediction of clinical outcomes 21 – 26 and some new risk assessment tools incorporating new biomarkers for cardiovascular events in ACSs have been created too. 27 – 31 All of the improvements of these risk prediction tools were mainly to improve the accuracy of the prognosis of ACS. However, until now, there is no assessment tool for the long-term prognosis of AMI patients over 80 years old.…”

Section: Discussionmentioning

confidence: 99%

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

Fu¹,

Yang²,

Shen³

et al. 2018

CIA

View full text Add to dashboard Cite

Background and aimsThis study sought to evaluate the prognostic powers of combined use of cystatin C (Cys C) and homocysteine (Hcy) at predicting adverse events of patients >80 years old with acute myocardial infarction (AMI).Patients and methodsThe analysis involved 753 patients >80 years old undergoing coronary angiography for chest pain in China from January 2006 to December 2012. Kaplan–Meier method was used for survival and major adverse cardiac events (MACE) rates. Multivariate Cox regression was performed to identify mortality predictors. Receiver operating characteristic curve analysis was performed to predict the cutoff values of Cys C and Hcy for all-cause mortality.ResultsThe duration of follow-up was 40–116 months (median, 63 months; interquartile range, 51–74 months). The long-term survival and event-free survival rates of AMI patients were significantly lower than those of unstable angina pectoris patients (P<0.05), and were significantly different according to the tertile concentration of Cys C of AMI patients (P<0.01). Cys C and Hcy were independent risk factors for long-term all-cause mortality (odds ratio [OR] =3.72 [2.27–6.09]; OR =1.59 [1.04–2.61]) and MACE (OR =2.83 [1.82–4.40]; OR =1.09 [1.04–1.21]) of AMI patients. The predictive cutoff value of Cys C was 1.815 mg/L (82.8%, 86.4%) and that of Hcy was 15.06 μmol/L (84.4%, 83.1%) in AMI patients. Combined use of both biomarker’s cutoff values further increased the sensitivity and specificity of all-cause mortality.ConclusionCys C is a strong independent predictor of long-term all-cause death and MACE in very old AMI patients. The combined use of Cys C and Hcy further improves the predictive accuracy.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

Fu¹,

Yang²,

Shen³

et al. 2018

CIA

View full text Add to dashboard Cite

show abstract

“…As noted by Mehta et al 1 , the American, European, and Canadian guidelines each recommend that all patients with ACS undergo risk stratification. Risk stratification is important because clinicians do not assess risk accurately 25 and because level of risk determines optimal treatment.…”

Section: Discussionmentioning

confidence: 99%

Predicting Prognosis in Acute Coronary Syndromes: Makeover Time for TIMI and GRACE?

Waters

Arsenault

2016

Canadian Journal of Cardiology

View full text Add to dashboard Cite

See article by Mehta et al., pages xxx-xxx of this issue.In this issue, Mehta et al.1 introduce a new risk score for patients with noneST-elevation acute coronary syndrome. The score is derived from 6447 of the patients in the Clopidogrel to prevent Recurrent Events trial who had baseline measurements of C-reactive protein (CRP), NT-pro-brainnatriuretic peptide (NT-proBNP), and haemoglobin A1C (HbA1C). The score is a composite of clinical variables (age, gender, prior myocardial infarction [MI] or stroke, ST deviation, elevated troponin T), and categories of NT-proBNP and HbA1C, and can range from 0 to 20. Although each of the 3 biomarkers predicted cardiovascular (CV) events, only NT-proBNP and HbA1C improved model discrimination, and thus were retained in the score.CV death, MI, or stroke within 1 year occurred in 3.7%, 9.1%, and 17.8% of low-, intermediate-, and high-score groups, respectively. The absolute benefit of dual antiplatelet therapy compared with aspirin alone was 1.0%, 4.7%, and 3.0% in low-, intermediate-, and high-risk groups, indicating the risk stratification aids in selection of patients with none ST-elevation acute coronary syndrome for this therapy.

show abstract

“…The seven-component OASIS risk score that was created by using five classical risk markers (age, gender, history of MI or stroke, ST-segment deviation and Troponin T) and two additional biomarkers (NT-proBNP and HbA1C) was found to be superior to the TIMI and GRACE risk scores in predicting the one-year rate of the composite endpoint of CV death/MI/stroke in NSTE ACS cases. The NT-proBNP values used in this scoring system was evaluated in four quartiles and the scoring system looks quite complex and unpractical (226).…”

Section: Can Natriuretic Peptides Contribute To Other Risk Stratificamentioning

confidence: 99%

Natriuretic Peptides in Clinical Practice

Çavuşoğlu

Alper²,

Altay³

et al. 2019

Anatol J Cardiol

View full text Add to dashboard Cite

Natriuretic peptides (NP) are commonly used diagnostic biomarkers in heart failure (HF). While the American HF guideline strongly recommends NPs as class I indication with the level of evidence A in the diagnosis of both acute and chronic HF (1), the European HF guideline recommends them as class I indicationwith the level of evidence A for acute HF and as class IIa indication with the level of evidence C for chronic HF (2). Similarly, NPs have been proven to be strong biomarkers for prognosis and risk assessment in HF. The American HF guideline recommends NPs as class I indication with the level of evidence A in the assessment of prognosis of both acute and chronic HF (1). Moreover, the American HF guideline recommends NP monitorization as class IIa indication with the level of evidence B for achieving optimal treatment target in chronic HF (1). However, it Natriuretic peptides have long been introduced into clinical practice. These biomarkers have certainly been shown to provide useful information in the diagnosis, prognosis and risk stratification in heart failure and also may have a role in the guidance of heart failure therapy. Although, there are some limitations in using of these markers such as lack of specificity, aging, renal dysfunction or obesity, among the huge number of candidates for heart failure biomarkers, only natriuretic peptides are currently widely used in daily clinical practice in heart failure. Recent heart failure guidelines recognize natriuretic peptides as an essential tool in the new diagnostic and therapeutic algorithms. Furthermore, natriuretic peptides are not only used in the diagnosis or prognosis of heart failure, but also these biomarkers are referred to have some potential role in primary prevention, cardio-oncology, advanced heart failure, assessment of response to cardiac resynchronization therapy, pulmonary arterial hypertension, acute coronary syndromes, atrial fibrillation and valvular heart disease. In this article, natriuretic peptides have been reviewed for their updated information and new recommendations in heart failure and also potential role of these biomarkers in the management of various clinical conditions have been addressed in the form of expert opinion based on the available data in the literature.

show abstract

A Risk Assessment Tool Incorporating New Biomarkers for Cardiovascular Events in Acute Coronary Syndromes: The Organization to Assess Strategies in Ischemic Syndromes (OASIS) Risk Score

Cited by 11 publications

References 25 publications

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

Prognostic ability of cystatin C and homocysteine plasma levels for long-term outcomes in very old acute myocardial infarction patients

Predicting Prognosis in Acute Coronary Syndromes: Makeover Time for TIMI and GRACE?

Natriuretic Peptides in Clinical Practice

Contact Info

Product

Resources

About