TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE‐ACS

Gonçalves, Pedro de Araújo; Ferreira, Jorge; Aguíar, Carlos; Seabra-Gomes, R

doi:10.1093/eurheartj/ehi187

Cited by 486 publications

(286 citation statements)

References 20 publications

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“…25 A comparison of TIMI, GRACE and PURSUIT scores concluded that all three risk scores demonstrated "good predictive accuracy for death or myocardial infarction at 1 year, and enabled the identification of high-risk subsets of patients who will benefit most from myocardial revascularization performed during initial hospital stay." 26 So why did these risk scores fare poorly in our study of patients who presented to the ED with potential ACS? Firstly, we should note that the ROC areas of 0.757 and 0.728 cited above do not suggest excellent predictive value.…”

Section: Discussionmentioning

confidence: 92%

Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain

Halpern

Deutsch

Hannaway

et al. 2013

The American Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 92%

Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain

Halpern

Deutsch

Hannaway

et al. 2013

The American Journal of Emergency Medicine

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“…Due to its high predictive accuracy it is nowadays the most widely used risk score in ACS. 13 More recently, both the Mayo Clinic and the National Cardiovascular Data Registry developed risk scores for patients undergoing coronary angioplasty. 2,3 Both scores included patients with ACS.…”

Section: Discussionmentioning

confidence: 99%

Validation of two US risk scores for percutaneous coronary intervention in a single-center Portuguese population of patients with acute coronary syndrome

Timóteo

Monteiro

Portugal

et al. 2016

Revista Portuguesa de Cardiologia (English Edition)

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Introduction: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. Methods: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs. expected mortality, and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analysis to compare the scores. Results: A total of 2148 consecutive patients were included, mean age 63 years (SD 13), 74% male and 71% with ST-segment elevation ACS. In-hospital mortality was 4.5%. The GRACE score showed the best AUC (0.94, 95% CI 0.91---0.96) compared with NCDR (0.87, 95% CI 0.83---0.91, p=0.0003) and MCRS (0.85, 95% CI 0.81---0.90, p=0.0003). In model calibration analysis, GRACE showed the best predictive power. With GRACE, patients were more often correctly classified than with MCRS (NRI 78.7, 95% CI 59.6---97.7; IDI 0.136, 95% CI 0.073---0.199) or NCDR (NRI 79.2, 95% CI 60.2---98.2; IDI 0.148, 95% CI 0.087---0.209). Conclusion: The NCDR and Mayo Clinic risk scores are useful for risk stratification of in-hospital mortality in a European population of patients with ACS undergoing coronary angioplasty. However, the GRACE score is still to be preferred. (NRI 78,7, IC 95% 59,7; IDI 0,136, IC 95% 0,199) e NCDR (NRI 79,2, IC 95% 60,2 ---98,2; IDI 0,148, IC 95% 0,087 ---0,209). Conclusão: Os scores NCDR e MC são úteis na estratificação de risco para mortalidade hospitalar numa população europeia de doentes com SCA submetidos a angioplastia coronária. Contudo, o score GRACE continua a ser o ideal. PALAVRAS-CHAVE

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“…7 They have looked at short-term as well as long-term mortality. They have clearly demonstrated that GRACE score was the best in predicting the risk of death or MI at 1 year after admission.…”

Section: Grace Scoring Systemmentioning

confidence: 99%

Composite risk scores for acute coronary syndromes

Chandra

2012

Indian Heart Journal

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TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE‐ACS

Abstract: The RSs studied demonstrated a good predictive accuracy for death or MI at 1 year and enabled the identification of high-risk subsets of patients who will benefit most from myocardial revascularization performed during initial hospital stay.

Cited by 486 publications

References 20 publications

Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain

Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain

Validation of two US risk scores for percutaneous coronary intervention in a single-center Portuguese population of patients with acute coronary syndrome

Composite risk scores for acute coronary syndromes

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