The value of GRACE risk score for predicting mortality in heart failure patients admitted with non-ST elevation acute coronary syndrome
| Autor: | A Cordero, J Martinon-Martinez, Carla Díaz-Louzao, V Jimenez-Ramos, I Gomez-Otero, José Ramón González-Juanatey, P Zuazola, N Bouzas Cruz, Belén Álvarez-Álvarez, F Gude-Sampedro, F Garcia-Rodeja, T Gonzalez-Ferrero, Vicente Bertomeu-González |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | EUROPEAN HEART JOURNAL r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 1522-9645 |
| Popis: | Background Acute coronary syndrome (ACS) in heart failure (HF) patients has not been well studied yet. Purpose The main aims of this study were to compare the characteristics and outcomes of Non-ST elevation ACS (NSTACS) in patients with and without prior HF, and to assess the GRACE risk score performance for risk stratification in both groups. Methods All consecutive patients (n=5661) admitted due to a NSTACS from November'2003 to November'2017 in two Spanish hospitals were retrospectively analysed. Patients were divided according to prior HF. As GRACE score predicts mortality in 6 months, logistic regression models were used to predict mortality in both groups. The different aspects of model performance were studied, including calibration and discrimination. Results Killip class, GRACE and CRUSADE scores were higher in HF-patients compared to patients without prior HF. Also, HF-patients had more complications (major bleeding, worsening HF, acute kidney injury) and higher mortality. Discrimination capacity of GRACE score to predict mortality at 6 months was slightly higher in non-HF patients (AUC 83.9% [81.6–86.2]) than in HF-patients [AUC 77.0% [70.1–83.8]) (Figure 1). The risk score calibration was acceptable for both groups [Brier scores were 0.139 (c-AUC 0,77) for HF-patients, and 0.046 (c-AUC 0.839) for non-HF patients]. Finally, HF-patients with lower GRACE scores had a higher predicted mortality than non-HF patients (Table 1). Conclusions We showed the potential utility of GRACE risk score in HF-patients admitted with NSTACS, expanding the indication of GRACE risk score for HF-patients as well. In fact, GRACE risk score not only keeps its accuracy, but it is even more robust in HF-patients than in non-HF patients. Funding Acknowledgement Type of funding sources: None. Figure 1Table 1 |
| Databáze: | OpenAIRE |
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