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. 2013 Sep;101(3):197-204.
doi: 10.5935/abc.20130163. Epub 2013 Aug 14.

Prospective validation of the Dante Pazzanese risk score in non-ST-segment elevation acute coronary syndrome

[Article in English, Portuguese]
Elizabete Silva Dos Santos, Luiz Minuzzo, Roberta de Souza, Ari Timerman

Prospective validation of the Dante Pazzanese risk score in non-ST-segment elevation acute coronary syndrome

[Article in English, Portuguese]
Elizabete Silva Dos Santos et al. Arq Bras Cardiol. 2013 Sep.

Abstract

Background: In non-ST-segment elevation acute coronary syndrome (ACS), the likelihood of adverse events should be estimated. Guidelines recommend risk stratification models for that purpose. The Dante Pazzanese risk score (DANTE score) is a simple risk stratification model composed with the following variables: age increase (0 to 9 points); history of diabetes mellitus (2 points) or stroke (4 points); no use of angiotensin-converting-enzyme inhibitor (1 point); creatinine elevation (0 to 10 points); combination of troponin elevation and ST-segment depression (0 to 4 points).

Objective: To validate the DANTE score in patients with non-ST-segment elevation ACS.

Methods: Prospective, observational study including 457 patients, from September 2009 to October 2010. The patients were grouped in risk categories according to the original model score as follows: very low; low; intermediate; and high. The predictive ability of the score was assessed by using C-statistics.

Results: The sample comprised 291 (63.7%) men, the mean age being 62.1 years (SD=11.04). The event death or (re)infarction in 30 days was observed in 17 patients (3.7%). Progressive increase in the proportion of events was observed as the score increased: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; high risk = 60.0%; p < 0.0001. C-statistics was 0.87 (95% CI: 0.81-0.94; p < 0.0001).

Conclusion: DANTE score showed an excellent capacity to predict the specific events, and can be incorporated to the prognostic assessment of patients with non-ST-segment elevation ACS.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
DANTE risk score for non-ST-segment elevation acute coronary syndrome. ACEI: angiotensin-converting-enzyme inhibitor; EKG: electrocardiogram.
Chart 1
Chart 1
DANTE score event: death or (re)infarction in 30 days; risk categories of the DANTE score: very low = 0 to 5 points; low = 6 to 10 points; intermediate = 11 to 15 points; high = 16 to 30 points.
Chart 2
Chart 2
Mean and median of the DANTE score of patients with and without the event death or (re)infarction in up to 30 days. Patients without the event of the DANTE score: mean: 6.2 (SD=2.9), median: 6.0 (25th percentile = 4.0; 75th percentile = 8.0); patients with the event of the DANTE score: mean: 11.5 (SD=3.4), median: 10.0 (25th percentile = 9.0; 75th percentile = 15.0); p < 0.0001.
Chart 3
Chart 3
Area under the receiver operating characteristic (ROC) curve for the occurrence of the event death or (re)infarction in 30 days, using the DANTE score. C-statistics, 0.87; 95% confidence interval: 0.81-0.94, p < 0.0001.
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