Comparison of the Prognostic Predictive Value of the TIMI, PAMI, CADILLAC, and GRACE Risk Scores in STEACS Undergoing Primary or Rescue PCI

• Published in: Revista española de cardiología (English ed.) 2012-03, Vol.65 (3), p.227-233
• Main Authors: Méndez-Eirín, Elizabet, Flores-Ríos, Xacobe, García-López, Fernando, Pérez-Pérez, Alberto J., Estévez-Loureiro, Rodrigo, Piñón-Esteban, Pablo, Aldama-López, Guillermo, Salgado-Fernández, Jorge, Calviño-Santos, Ramón A., Vázquez Rodríguez, José M., Vázquez-González, Nicolás, Castro-Beiras, Alfonso
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - surgery; Acute myocardial infarction; Aged; Angioplasty, Balloon, Coronary; Antibodies, Monoclonal - therapeutic use; Cardiopatía isquémica; Cohort Studies; Coronary Disease - complications; Coronary Disease - mortality; Coronary Disease - surgery; Female; Humans; Immunoglobulin Fab Fragments - therapeutic use; Infarto agudo de miocardio; Ischemic heart disease; Logistic Models; Male; Middle Aged; Myocardial Infarction - drug therapy; Myocardial Infarction - surgery; Myocardial Revascularization; Platelet Aggregation Inhibitors - therapeutic use; Postoperative Complications - drug therapy; Postoperative Complications - mortality; Predictive Value of Tests; Prognosis; Recurrence; Registries; Retrospective Studies; Revascularización de vaso tratado; Risk Assessment; ROC Curve; Síndrome coronario agudo; Target-vessel revascularization; Thrombolytic Therapy; Treatment Outcome
• ISSN: 1885-5857; 1885-5857
• DOI: 10.1016/j.rec.2011.10.021

We sought to compare the predictive value of the Thrombolysis In Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), Primary Angioplasty in Myocardial Infarction (PAMI), and Global Registry for Acute Coronary Events (GRACE) scores for the outcome of ST-segment elevation acute coronary syndrome undergoing urgent percutaneous coronary intervention. We performed a retrospective analysis of a cohort composed of all consecutive patients with ST-segment elevation acute coronary syndrome treated by urgent percutaneous coronary intervention between 2006 and 2010 (n=1503). TIMI, PAMI, CADILLAC, and GRACE risk scores were calculated for each patient according to different clinical variables. We assessed the predictive accuracy of these scores for death, reinfarction, and target-vessel revascularization at 30 days and 1 year, using the C statistic, which was obtained by means of logistic regression and ROC curves. The TIMI, PAMI, CADILLAC and GRACE showed an excellent predictive value for 30-day and 1-year mortality (C statistic range, 0.8-0.9), with superiority of the TIMI, CADILLAC, and GRACE risk models. The performance of these 4 scores was poor for both reinfarction and target-vessel revascularization (C statistic, 0.5-0.6). The TIMI, PAMI, CADILLAC, and GRACE scores provide excellent information to stratify the risk of mortality in patients treated by percutaneous coronary intervention. The TIMI, CADILLAC, and GRACE models have higher predictive accuracy. The usefulness of these models for reinfarction and target-vessel revascularization prediction is questionable. Nos planteamos comparar el valor predictivo pronóstico de los scores de riesgo Thrombolysis In Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), Primary Angioplasty in Myocardial Infarction (PAMI) y Global Registry for Acute Coronary Events (GRACE) para el síndrome coronario agudo con elevación del ST sometido a intervencionismo coronario percutáneo urgente. Análisis retrospectivo de una cohorte compuesta por todos los pacientes con un síndrome coronario agudo con elevación del ST tratados en nuestro centro mediante intervencionismo coronario percutáneo urgente entre 2006-2010 (n=1.503). Para cada paciente, calculamos la puntuación de los scores TIMI, PAMI, CADILLAC y GRACE según diferentes variables clínicas. Valoramos el valor predictivo de los cu