Predictive Validity of CRUSADE, ACTION and ACUITY-HORIZONS Bleeding Risk Scores in Chinese Patients With ST-Segment Elevation Myocardial Infarction

Liu, Ran; Zheng, Wen; Zhao, Guoqiang; Wang, Xiao; Zhao, Xiaofeng; Zhou, Shenghui; Nie, Shaoping

doi:10.1253/circj.cj-17-0760

Cited by 9 publications

(5 citation statements)

References 31 publications

(15 reference statements)

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“…Several studies have compared both scores, finding a similar predictive capacity. (20,21) A recent meta-analysis, (19) of 17 studies with more than 18 thousand patients, reported a moderate predictive capacity of both scores (AUC 0.71 and 0.76, respectively), somewhat higher than that found in our work (0.68 and 0.70).…”

Section: Action_gwtg Orbit Crusadecontrasting

confidence: 67%

Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome

Navarta¹,

Pinel²,

Vitale³

et al. 2022

Rev Argent Cardiol

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Background: Major bleeding is the most important complication of antithrombotic treatment in acute coronary syndrome (ACS) and is associated with higher mortality. Assessing the risk of bleeding is a challenge. The usefulness of the Orbit Bleeding Score (ORBIT) to assess the risk of bleeding in ACS has been scarcely studied. Objective: The aim of this study was to evaluate the ORBIT score as a predictor of major bleeding in patients hospitalized for ACS in whom anticoagulation is decided as part of the antithrombotic strategy. Methods: Patients admitted to two coronary care units with diagnosis of ACS who received anticoagulation as part of the antithrombotic therapy were retrospectively included in the study. The CRUSADE, ACTION-GWTG and ORBIT scores were calculated using the admission clinical data. The primary endpoint was major bleeding, defined as BARC 3 or 5 classification. Results:The study included 762 patients. Major bleeding occurred in 3.4% of cases. In the univariate analysis, the three scores were predictors of major bleeding, while in the multivariate analysis only the ORBIT score was an independent predictor of major bleeding (OR: 2.46, 95% CI 1.61-3.97, p <0.001). The area under the ROC curve was 0.70, 0.68 and 0.80 for the ACTION-GWTG, CRUSADE and ORBIT scores, respectively. The ORBIT score presented a higher area under the curve than the CRUSADE score (p=0.03) but without significant difference with the ACTION-GWTG score (p=0.06) Conclusions: The ORBIT score was the only independent predictor of major bleeding, presenting a better discrimination capacity than the CRUSADE score and a tendency to better capacity than the ACTION-GWTG score.

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Section: Action_gwtg Orbit Crusadecontrasting

confidence: 67%

Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome

Navarta¹,

Pinel²,

Vitale³

et al. 2022

Rev Argent Cardiol

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“…(18,19) El ACTION-GWTG fue desarrollado incluyendo pacientes con SCA con y sin elevación de ST. Varios estudios han comparado ambos scores encontrando similar capacidad predictiva. (20,21)Un metaanálisis reciente, (19) sobre 17 estudios con más de 18 mil pacientes, reportó una moderada capacidad predictiva en ambos scores (ABC: 0,71 y 0,76, respectivamente), algo mayor que la encontrada en nuestro trabajo (0,68 y 0,70).…”

Section: Discussionunclassified

Evaluación del Orbit Bleeding Risk Score como predictor de sangrado mayor en pacientes con síndrome coronario agudo

Navarta

Pinel²,

Vitale³

et al. 2023

Rev Argent Cardiol

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Introducción: El sangrado mayor es la complicación más importante del tratamiento antitrombótico en el síndrome coronarioagudo (SCA), y se asocia a mayor mortalidad. Evaluar el riesgo de sangrado es un desafío. La utilidad del Orbit Bleeding score(ORBIT) para evaluar el riesgo de sangrado en SCA ha sido poco estudiada.Objetivo: Evaluar al ORBIT como predictor de sangrado mayor en pacientes internados por SCA en los que se decide la anticoagulación como parte de la estrategia antitrombótica.Materiales y métodos: Se incluyeron en forma retrospectiva pacientes internados en dos unidades coronarias con diagnósticode SCA que recibieron anticoagulación como parte de la terapia antitrombótica. A todos se les calcularon los scores CRUSADE,ACTION-GWTG y ORBIT con los datos clínicos del ingreso. Se analizo el punto primario de sangrado mayor, definido como una clasificación de BARC 3 o 5.Resultados: Se incluyeron 762 pacientes. El sangrado mayor se presentó en el 3.4%. En el análisis univariado los tres scores fueron predictores de sangrado mayor, mientras que en el multivariado sólo el ORBIT fue predictor independiente de sangrado mayor, con OR 2,46, IC95% 1,61-3,97, p <0,001. El área bajo la curva ROC fue de 0,70, 0,68 y 0,80 para los scores ACTIONGWTG, CRUSADE y ORBIT, respectivamente. El ORBIT presento una mayor área bajo la curva que el CRUSADE (p = 0,03) sin diferencias significativas con el ACTION-GWTG (p = 0,06) Conclusiones: El ORBIT fue el único predictor independiente de sangrado mayor, con una mejor capacidad de discriminaciónque el CRUSADE, y tendencia a mejor capacidad que el ACTION-GWTG.

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“…12,13) A recent Chinese cohort study by Liu, et al also showed CRUSADE and ACTION scores having greater predictive ability for in-hospital major bleeding than the ACUITY-HORIZONS RS in Chinese STEMI patients undergoing PCI. 14) However, different from the study of Liu, et al, our study cohort included both STEMI and NSTEMI patients. Compared with NSTEMI patients, STEMI patients generally have a lower prevalence of comorbidities and shorter hospital-associated delays.…”

Section: Comparison Of Rsmentioning

confidence: 98%

Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

et al. 2019

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We investigated the accuracy of various bleeding risk scores to estimate the bleeding risk in patients with acute myocardial infarction (AMI) managed with percutaneous coronary intervention (PCI) access via the radial artery. We retrospectively enrolled 1,651 patients who were definitively diagnosed with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI). We assessed the predictive validities of 30-day bleeding events in various scoring systems using receiver operating characteristic curves. Overall, ACUITY-HORIZONS exhibited the highest area under the curve to predict 30-day bleeding, followed by ACTION and CRUSADE; HAS-BLED displayed the lowest score. With a cutoff of 17, ACUITY-HORIZONS demonstrated the best discrimination for the Thrombolysis in Myocardial Infarction (TIMI) 30-day serious bleeding rate. We observed significant differences among all-cause death, cardiovascular death, and major adverse cardiac events between the ACUITY-HORIZONS groups with a score of !17 and > 17. ACUITY-HORIZONS score > 17, initial systolic blood pressure (SBP) < 90 mmHg, and Killip III and IV upon admission positively predicted the 30-day bleeding risk, whereas myocardial infarction (MI) and TIMI major bleeding within 30 days, heart failure at admission, and initial SBP < 90 mmHg positively predicted the 30-day mortality. Comparatively, ACUITY-HORIZON is the most reliable system in predicting 30-day bleeding for patients with AMI via transradial PCI. In the transradial scenario, bleeding and MI within 30 days are substantially related to 30-day mortality.

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Predictive Validity of CRUSADE, ACTION and ACUITY-HORIZONS Bleeding Risk Scores in Chinese Patients With ST-Segment Elevation Myocardial Infarction

Cited by 9 publications

References 31 publications

Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome

Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome

Evaluación del Orbit Bleeding Risk Score como predictor de sangrado mayor en pacientes con síndrome coronario agudo

Evaluation of Bleeding Risk in Patients with Acute Myocardial Infarction Undergoing Transradial Percutaneous Coronary Intervention

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