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Observational Study
. 2018;27(5):459-465.
doi: 10.1159/000489399. Epub 2018 Apr 19.

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Erdal Aktürk, Lütfü Aşkın, Hakan Taşolar, Serdar Türkmen, Hakan Kaya
Observational Study

Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Erdal Aktürk et al. Med Princ Pract. 2018.

Abstract

Objective: We evaluated the relationship between various risk scores (SYNTAX score [SS], SYNTAX score-II [SS-II], thrombolysis in myocardial infarction [TIMI] risk scores, and Global Registry of Acute Coronary Events [GRACE] risk scores) and major adverse cardiovascular events (MACE) in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI).

Subjects and methods: The study population were selected from among 589 patients who underwent coronary angiography with a diagnosis of NSTEMI. TIMI and GRACE risk scores were calculated. SS and SS-II were calculated in all patients, and points were added according to the predefined algorithm, taking into account the other 6 clinical variables being monitored (age, sex, left ventricular ejection fraction, creatinine clearance, chronic obstructive pulmonary disease, and peripheral artery disease). Patients were classified into tertile 1 (SS < 22), tertile 2 (SS 23-32), and tertile 3 (SS > 32).

Results: The group with high SS-II for PCI values in the risk scores were observed from tertile 1 to tertile 3 (from 25.0 ± 7.7 to 31.6 ± 9.4, p < 0.001, respectively). The SS-II score in patients with PCI was an independent predictor of MACE, in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis (OR 1.082, 95% CI 1.036-1.131, p < 0.001). The overall MACE, in-hospital mortality, and nonfatal myocardial infarction rates were significantly higher in the high SS-II for PCI group (p < 0.001).

Conclusion: TIMI and GRACE risk scores were able to predict MACE. In addition to these, SS-II was also able to predict in-hospital mortality, nonfatal myocardial infarction, and stent thrombosis.

Keywords: Cardiovascular events; Non-ST elevation myocardial infarction; Risk scores.

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Figures

Fig. 1
Fig. 1
Comparison of ROC curves of the SS-II score, TIMI, and GRACE scores in the risk stratification of in-hospital MACE in NSTE-ACS patients. CABG, coronary artery bypass graft.
Fig. 2
Fig. 2
The SS-II value for PCI > 27.9 predicted in-hospital mortality with a sensitivity of 64.5% and specificity of 63.0%.
See this image and copyright information in PMC

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