Comparison of the Prognostic Predictive Value of the TIMI, PAMI, CADILLAC, and GRACE Risk Scores in STEACS Undergoing Primary or Rescue PCI

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• 作者：Elizabet Mé ; ndez-Eir&#237 ; n ; Xacobe Flores-R&#237 ; os ; ^{xacobeflores@yahoo.es} ; Fernando Garc&#237 ; a-Ló ; pez ; Alberto J. Pé ; rez-Pé ; rez ; Rodrigo Esté ; vez-Loureiro ; Pablo Piñ ; ó ; n-Esteban ; Guillermo Aldama-Ló ; pez ; Jorge Salgado-Ferná ; ndez ; Ramó ; n A. Calviñ ; o-Santos ; José ; M. Vá ; zquez Rodr&#237 ; guez ; Nicolá ; s Vá ; zquez-Gonzá ; lez ; Alfonso Castro-Beiras
• 关键词：ACS ; acute coronary syndrome ; AMI ; Acute myocardial infarction ; PCI ; percutaneous coronary intervention ; STEACS ; ST-segment elevation acute coronary syndrome ; TVR ; target-vessel revascularization
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2012
• 出版时间：March, 2012
• 年：2012
• 卷：65
• 期：3
• 页码：227-233
• 全文大小：238 K

文摘

Introduction and objectives

We sought to compare the predictive value of the Thrombolysis In Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), Primary Angioplasty in Myocardial Infarction (PAMI), and Global Registry for Acute Coronary Events (GRACE) scores for the outcome of ST-segment elevation acute coronary syndrome undergoing urgent percutaneous coronary intervention.

Methods

We performed a retrospective analysis of a cohort composed of all consecutive patients with ST-segment elevation acute coronary syndrome treated by urgent percutaneous coronary intervention between 2006 and 2010 (n=1503). TIMI, PAMI, CADILLAC, and GRACE risk scores were calculated for each patient according to different clinical variables. We assessed the predictive accuracy of these scores for death, reinfarction, and target-vessel revascularization at 30 days and 1 year, using the C statistic, which was obtained by means of logistic regression and ROC curves.

Results

The TIMI, PAMI, CADILLAC and GRACE showed an excellent predictive value for 30-day and 1-year mortality (C statistic range, 0.8-0.9), with superiority of the TIMI, CADILLAC, and GRACE risk models. The performance of these 4 scores was poor for both reinfarction and target-vessel revascularization (C statistic, 0.5-0.6).

Conclusions

The TIMI, PAMI, CADILLAC, and GRACE scores provide excellent information to stratify the risk of mortality in patients treated by percutaneous coronary intervention. The TIMI, CADILLAC, and GRACE models have higher predictive accuracy. The usefulness of these models for reinfarction and target-vessel revascularization prediction is questionable.