Validity of the updated GRACE risk predictor (version 2.0) in patients with non-ST-elevation acute coronary syndrome

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• 作者：Sukru Akyuz^a ; ^{sukruakyuz@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Selcuk Yazici^a ; Emrah Bozbeyoglu^a ; Tolga Onuk^a ; Ozlem Yildirimturk^a ; Denizhan Karacimen^b ; Mert Ilker Hayiroglu^a ; Guney Erdogan^c ; Abdullah Orcun Oner^d ; Ali Nazmi Calik^e ; Metin Cagdas^d ; Nese Cam^a
• 关键词：Acute coronary syndrome ; GRACE risk score ; Mortality ; Prognosis ; Risk assessment
• 刊名：Revista Portuguesa de Cardiologia (English Edition)
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：35
• 期：1
• 页码：25-31
• 全文大小：417 K

文摘

A new version of the Global Registry of Acute Coronary Events (GRACE) risk score (version 2.0) has been released recently. The purpose of the present study was to assess the validity of GRACE 2.0 for in-hospital and 1-year mortality in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients.

Methods

The prospective cohort comprised 396 consecutive NSTE-ACS patients admitted to a tertiary hospital between May 2012 and January 2013. The main outcome measure was the discrimination and calibration performance of GRACE 2.0, which were evaluated with the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit test, respectively.

Results

In-hospital and 1-year mortality were 2% (8/396) and 12.4% (48/388), respectively. The discrimination performance was inadequate (AUC=0.62) for predicting in-hospital mortality for the overall cohort. Also, the calibration performance for in-hospital mortality could not be evaluated due to the low number of patients who died. At one year, the Hosmer-Lemeshow p-values for all subgroups were >0.05, suggesting a good model fit, and the discrimination performance was good (AUC=0.77) for the overall cohort, driven mainly by better accuracy for low-risk patients.

Conclusions

In a contemporary cohort of NSTE-ACS patients, GRACE 2.0 was valid for 1-year mortality assessment. Its value for in-hospital mortality requires validation in a larger cohort.