POSSIBILITIES FOR RISK ASSESSING IN PATIENTS WITH ACUTE CORONARY SYNDROME OLDER THAN 75 YEARS

Autor:	Victoria Brazhnik, Larisa O. Minushkina, D A Zateyshchikov, Ekaterina Zubova
Rok vydání:	2019
Předmět:	Acute coronary syndrome Pediatrics medicine.medical_specialty Framingham Risk Score business.industry General Medicine After discharge medicine.disease Age groups Medicine In patient Risk of death business Risk assessment Area under the roc curve
Zdroj:	Medical Journal of the Russian Federation. 25:268-273
ISSN:	2412-9100 0869-2106
Popis:	The aim of the study was to assess the possibility of using risk assessment scales for adverse outcomes in patients with acute coronary syndrome (ACS) of older age groups. Materials and methods. The study included 988 patients with ACS who were followed up within 1 year after discharge from the hospital as part of the ORACLE II study. The average age of patients was 61.7±4.22 years, 582 (58.9%) men, 405 (40.1%) women. Results of the study: Within 1 year of observation, death from any causes was recorded in 52 (8.2%) patients younger than 75 years old and in 89 (26.6%) patients older than 74 years; coronary outcomes - in 80 patients (12.4%) under the age of 75 years and in 80 patients (23.3%) aged 75 years and older. Any adverse outcome, including atherothrombotic events and bleeding, was recorded during the year in 148 (43.1%) patients of the older age group and in 211 (32.7%) patients under 75 years of age. In patients younger than 75 years, when predicting the risk of death using the GRACE risk score, the area under the ROC curve was 0.794, in the group of patients over 75 years old it was only 0.575, which indicates a low diagnostic value. Similar data were obtained regarding the risk of coronary events. The Russian RECORD scale had the best predictive ability with respect to the prognosis of mortality in patients older than 75 years. the area under the ROC curve was 0.691, as well as in predicting repeated ischemic events in both subgroups. Conclusions: widely used scales for assessing the prognosis of mortality and recurring ischemic events, which well predict the prognosis in patients under 75 years of age in a group of patients older than 75 years have low prognostic value. The highest score in the older age group may have a risk score scale RECORD.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::61783aa7821e0b030846c7fde0606e6f https://doi.org/10.18821/0869-2106-2019-25-5-6-268-273 Zobrazit plný text záznamu