Does acute hyperglycemia add prognostic value to the GRACE score in individuals with non-ST elevation acute coronary syndromes?
| Autor: | Mário de Seixas Rocha, J. Péricles Esteves, Luis C. L. Correia, Ana P. Bittencourt, Rafael Freitas, Alexandre C. Souza, Maria C. Almeida |
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| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Clinical Biochemistry Biochemistry Predictive Value of Tests Risk Factors Internal medicine Diabetes mellitus Humans Medicine Myocardial infarction Acute Coronary Syndrome Adverse effect Intensive care medicine Aged Aged 80 and over Acute hyperglycemia business.industry ST elevation Incidence (epidemiology) Biochemistry (medical) General Medicine Middle Aged Prognosis medicine.disease Net reclassification improvement Hospitalization Quartile Hyperglycemia Cardiology Female business |
| Zdroj: | Clinica Chimica Acta. 410:74-78 |
| ISSN: | 0009-8981 |
| Popis: | Background It is not known in what extent admission glucose improves risk stratification of the GRACE Score in patients with non-ST-segment elevation acute coronary syndromes (ACS). We tested the hypothesis that admission glucose adds relevant prognostic information to the GRACE Score. Methods Consecutive patients admitted with ACS had plasma glucose measured at admission and cardiovascular events were defined as death, non-fatal myocardial infarction or non-fatal refractory angina during hospitalization. Results Among the 148 patients studied, 11.5% developed cardiovascular events. Patients in the forth quartile of admission glucose (≥ 175 mg/dl) had a greater incidence of events, compared with those in the first 3 quartiles (22% vs. 8.1%; RR = 2.7; 95%CI 1.1–6.4; P = 0.03). Plasma glucose remained a predictor of events, after adjustment for diabetes (P = 0.03). After adjustment for the GRACE Score, glucose in the forth quartile lost its predictive value (P = 0.29). Plasma glucose added to GRACE did not improve the C-statistics (0.82; 95%CI 0.75–0.88), as compared with the original Score (0.81; 95%CI 0.74–0.87). Net reclassification improvement by new score was − 0.03 (P = 0.86), indicating no useful reclassification. Conclusion Despite its association with adverse events, admission plasma glucose does not improve GRACE's accuracy to predict in-hospital events in patients with ACS. |
| Databáze: | OpenAIRE |
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