GRACE, TIMI, Zwolle and CADILLAC risk scores — Do they predict 5-year outcomes after ST-elevation myocardial infarction treated invasively?

• Published in: International journal of cardiology 2011-04, Vol.148 (1), p.70-75
• Main Authors: Kozieradzka, Anna, Kamiński, Karol Adam, Maciorkowska, Dominika, Olszewska, Magdalena, Dobrzycki, Slawomir, Nowak, Konrad, Kralisz, Pawel, Prokopczuk, Przemyslaw, Musial, Wlodzimierz Jerzy
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Angioplasty; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Coronary heart disease; Diseases of the cardiovascular system; Female; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Predictive Value of Tests; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Research Design - standards; Risk Assessment; STEMI; Survival; Survival Rate - trends; Treatment Outcome
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2009.10.026

Abstract Background GRACE, TIMI, Zwolle, and CADILLAC are risk scores designed for predicting short-term outcome after acute coronary syndromes. The aim of our study was to test their utility for a prognosis of 5-year survival in a “real-life” population of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (pPCI). Methods Our registry consisted of consecutive patients with STEMI treated with pPCI. Five-year follow-up was performed with all-cause mortality as the end-point. Results Out of 505 patients (mean age 58.6 ± 11.3 years) 32 died during the first 30 days (6.3%) and an additional 74 within 5 years (15.6%). PCI was successful in 95.2% ( n = 481). Prognostic values ( c statistics) for predicting 5-year mortality equaled: 0.742 (CI 0.69–0.79) for the GRACE risk score, 0.727 (CI 0.67–0.78) for TIMI, 0.72 (CI 0.67–0.77) for Zwolle, and 0.687 (CI 0.63–0.74) for CADILLAC. In a univariate analysis all the scores were associated with the 5-year outcome. Conclusions GRACE, TIMI, and Zwolle risk scores predicted well 5-year all-cause mortality in patients with STEMI treated with pPCI. Our data show that the usefulness of initial bedside risk assessment can be further extended for long-term follow-up.