Sukru Akyuz1, Selcuk Yazici2, Emrah Bozbeyoglu2, Tolga Onuk2, Ozlem Yildirimturk2, Denizhan Karacimen3, Mert Ilker Hayiroglu2, Guney Erdogan4, Abdullah Orcun Oner5, Ali Nazmi Calik6, Metin Cagdas5, Nese Cam2. 1. Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: sukruakyuz@hotmail.com. 2. Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. 3. Department of Cardiology, Suruc State Hospital, Sanliurfa, Turkey. 4. Department of Cardiology, Ordu State Hospital, Ordu, Turkey. 5. Department of Cardiology, Beykoz State Hospital, Istanbul, Turkey. 6. Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey.
Abstract
OBJECTIVES: 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.
OBJECTIVES: 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.