GRACE scores or high-sensitivity troponin for timing of coronary angiography in non-ST-elevation acute coronary syndromes

Background The GRACE risk score is generically recommended by guidelines for timing of invasive coronary angiography without stating which score should be used. The aim was to determine the diagnostic performance of different GRACE risk scores in comparison to the ESC 0/1 h-algorithm using high-sens...

Full description

Saved in:
Bibliographic Details
Published in:Clinical research in cardiology 2024-04, Vol.113 (4), p.533-545
Main Authors: Jobs, Alexander, Boeddinghaus, Jasper, Neumann, Johannes Tobias, Goßling, Alina, Sörensen, Nils A., Twerenbold, Raphael, Nestelberger, Thomas, Lopez-Ayala, Pedro, Gimenez, Maria Rubini, Miro, Oscar, Koechlin, Luca, Buergin, Natacha, Feistritzer, Hans-Josef, Collet, Jean-Philippe, Bhatt, Deepak L., Granger, Christopher B., Blankenberg, Stefan, Desch, Steffen, Mueller, Christian, Westermann, Dirk, Thiele, Holger
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - diagnosis
Algorithms
Angiography
Biomarkers
Cardiology
Coronary Angiography
Diagnostic systems
Humans
Medical imaging
Medicine
Medicine & Public Health
Myocardial infarction
Myocardial Infarction - diagnosis
Original Paper
Reclassification
Risk
Risk Assessment - methods
Sensitivity
Troponin
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background The GRACE risk score is generically recommended by guidelines for timing of invasive coronary angiography without stating which score should be used. The aim was to determine the diagnostic performance of different GRACE risk scores in comparison to the ESC 0/1 h-algorithm using high-sensitivity cardiac troponin (hs-cTn). Methods Prospectively enrolled patients presenting with symptoms suggestive of myocardial infarction (MI) in two large studies testing biomarker diagnostic strategies were included. Five GRACE risk scores were calculated. The amount of risk reclassification and the theoretical impact on guideline-recommended timing of invasive coronary angiography was studied. Results Overall, 8,618 patients were eligible for analyses. Comparing different GRACE risk scores, up to 63.8% of participants were reclassified into a different risk category. The proportion of MIs identified (i.e., sensitivity) dramatically differed between GRACE risk scores (range 23.8–66.5%) and was lower for any score than for the ESC 0/1 h-algorithm (78.1%). Supplementing the ESC 0/1 h-algorithm with a GRACE risk score slightly increased sensitivity ( P  
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-023-02258-5