Assessing risk post intervention for an acute coronary syndrome: A review of the risk assessment tools and their development

Abstract

Considerable variability in survival rate after an acute myocardial infarction exists and accurate risk stratification is of significant importance. The American College of Cardiology and the American Heart Association has recommended early risk stratification using several clinical risk scoring instruments to identify high risk patients. The aim of this paper is to identify secondary cardiovascular risk scoring instruments that could be utilized at the time of intervention for acute coronary syndromes and compare their psychometric properties as they were developed. A search using Medline, Cumulative Index to Nursing and Allied Health Literature and the Psychology and Behavioral Sciences Collection databases identified studies published between January 1990 and January 2010 used to measure risk after intervention for acute coronary syndrome. Four validated secondary risk prediction scoring instruments were identified for comparison. Secondary risk prediction scoring instruments for the acute coronary syndrome patient population are evidence based, valid and reliable. Use of the instruments by cardiac focused clinicians will aid in the determination of treatment strategies, and estimation of short and long term events and mortality.

Measuring Nurse Satisfaction with the Chest Pain Protocol

“…The CADILLAC, TIMI and PAMI risk scores accomplished valid prediction of re-infarction at 30 days, with the accuracy of risk scores ranging from 0.6-0.7, where the GRACE score had a low accuracy of 0.47. The GRACE score did not accurately predict mortality (Scruth, et al, 2012).…”

“…Creating a protocol to treat acute coronary syndrome required a multidisciplinary approach with equal input from physicians, nursing staff, cardiologists, administrators, laboratory personnel and pharmacists (Wessler, Stant, Duru, Rabbani & Kirtane, 2015). The early diagnosis and risk stratification of ST-elevation myocardial infarction (STEMI), non STelevation myocardial infarction (NSTEMI) and unstable angina were crucial to determine a plan of action, including guiding therapy and ultimately improved patient outcomes (Scruth, Worrall-Carter, Cheng, Rolley & Page, 2012). According to the research, a…”