Comparison of the Global Registry of Acute Coronary Events Risk Score Versus the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse outcomes With Early Implementation of the ACC/AHA Guidelines Risk Score to Predict In-Hospital Mortality and Major Bleeding in Acute Coronary Syndromes

• Published in: The American journal of cardiology 2016-04, Vol.117 (7), p.1047-1054
• Main Authors: Manzano-Fernández, Sergio, PhD, Sánchez-Martínez, Marianela, MD, Flores-Blanco, Pedro J., MD, López-Cuenca, Ángel, PhD, Gómez-Molina, Miriam, MD, Pastor-Pérez, Francisco J., PhD, Sánchez-Galian, María J., MD, Cambronero-Sanchez, Francisco, PhD, Guerrero Pérez, Esther, MD, García-Narbón, Andrea, MD, Heras-Gómez, Ignacio de las, MD, Valdés, Mariano, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - epidemiology; Acute coronary syndromes; Aged; Aged, 80 and over; Angina, Unstable - complications; Angina, Unstable - diagnosis; Angina, Unstable - therapy; Cardiology; Cardiovascular; Clinical Protocols; Female; Heart attacks; Hemorrhage - diagnosis; Hemorrhage - epidemiology; Hospital Mortality; Humans; Male; Middle Aged; Mortality; Registries; Retrospective Studies; Risk Assessment; ROC Curve
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2015.12.048

Risk assessment plays a major role in the management of acute coronary syndrome. The aim was to compare the performance of the Global Registry of Acute Coronary Events (GRACE) and the Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the American College of Cardiology/American Heart Asociation guidelines (CRUSADE) risk scores to predict in-hospital mortality and major bleeding (MB) in 1,587 consecutive patients with acute coronary syndrome. In-hospital deaths and bleeding complications were prospectively collected. Bleeding complications were defined according to CRUSADE and Bleeding Academic Research Consortium (BARC) criteria. During the hospitalization, 71 patients (4.5%) died, 37 patients (2.3%) had BARC MB and 34 patients (2.1%) had CRUSADE MB. Receiver operating characteristic curves analyses showed GRACE risk score has better discrimination capacity than CRUSADE risk score for both, mortality (0.86 vs 0.79; p = 0.018) and BARC MB (0.80 vs 0.73; p = 0.028), but similar for CRUSADE MB (0.79 vs 0.79; p = 0.921). Both scores had low discrimination for predicting MB in the elderly (>75 years) and patients with atrial fibrillation, whereas CRUSADE risk score was especially poor for predicting MB in patients with