Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2005 Aug;91(8):1047-52.
doi: 10.1136/hrt.2003.031369.

FRISC score for selection of patients for an early invasive treatment strategy in unstable coronary artery disease

B Lagerqvist  1 , E Diderholm, B Lindahl, S Husted, F Kontny, E Ståhle, E Swahn, P Venge, A Siegbahn, L Wallentin
Affiliations
Clinical Trial

FRISC score for selection of patients for an early invasive treatment strategy in unstable coronary artery disease

B Lagerqvist et al. Heart. 2005 Aug.

Abstract

Objective: To develop a scoring system for risk stratification and evaluation of the effect of an early invasive strategy for treatment of unstable coronary artery disease (CAD).

Design: Retrospective analysis of a randomised study (FRISC II; fast revascularisation in instability in coronary disease).

Setting: 58 Scandinavian hospitals.

Patients: 2457 patients with unstable CAD from the FRISC II study.

Main outcome measures: One year rates of mortality and death/myocardial infarction (MI).

Methods: Patients were randomly assigned to an early invasive or a non-invasive strategy. From the non-invasive cohort independent variables of death or death/MI were identified.

Results: Seven factors, age > 70 years, male sex, diabetes, previous MI, ST depression, and increased concentrations of troponins and markers of inflammation (interleukin 6 or C reactive protein), were associated with an independent increased risk for death or death/MI. In patients with > or = 5 of these factors the invasive strategy reduced mortality from 15.4% (20 of 130) to 5.2% (7 of 134) (risk ratio (RR) 0.34, 95% confidence interval (CI) 0.15 to 0.78, p = 0.006). Death/MI was also reduced in patients with 3-4 factors from 15.7% (80 of 511) to 10.8% (58 of 538) (RR 0.69, 95% CI 0.50 to 0.94, p = 0.02). Neither death nor death/MI was reduced in patients with 0-2 risk factors.

Conclusion: In unstable CAD, this scoring system based on factors independently associated with an adverse outcome can be used shortly after admission to the hospital for risk stratification and for selection of patients to an early invasive treatment strategy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
One year death (grey bars) and the composite of death and myocardial infarction (grey + white bars) in relation to FRISC score in the non-invasive cohort. By Mantel-Haenszel trend test, p < 0.001 for both death and death/myocardial infarction.
Figure 2
Figure 2
Distribution of severity of coronary artery disease at angiography in relation to FRISC score in the invasive cohort. 0 vessel disease (VD) = no significant stenosis. LMD, left main disease.
Figure 3
Figure 3
Number of patients with TIMI III flow in all major vessels in relation to FRISC score in the invasive cohort. By Mantel-Haenszel trend test, p < 0.001.
Figure 4
Figure 4
One year mortality in relation to treatment strategy and the FRISC score. White bars, non-invasive strategy; black bars, invasive strategy. Risk ratios (RR), confidence intervals, and p values refer to the comparison between the invasive and non-invasive strategies.
Figure 5
Figure 5
One year death or myocardial infarction in relation to treatment strategy and the FRISC score.
See this image and copyright information in PMC

References

    1. FRISC II Investigators. Invasive compared with non-invasive treatment in unstable coronary- artery disease: FRISC II prospective randomised multicentre study. FRagmin and Fast Revascularisation during InStability in Coronary artery disease Investigators. Lancet 1999;354:708–15. - PubMed
    1. Wallentin L, Lagerqvist B, Husted S, et al. Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery disease: the FRISC II invasive randomised trial. FRISC II Investigators. Fast revascularisation during instability in coronary artery disease. Lancet 2000;356:9–16. - PubMed
    1. Cannon CP, Weintraub WS, Demopoulos LA, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med 2001;344:1879–87. - PubMed
    1. Fox KA, Poole-Wilson PA, Henderson RA, et al. Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction: the British Heart Foundation RITA 3 randomised trial. Randomized intervention trial of unstable angina. Lancet 2002;360:743–51. - PubMed
    1. Savonitto S, Ardissino D, Granger CB, et al. Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA 1999;281:707–13. - PubMed