Abstract:Cardiovascular disease is the leading cause of mortality in Brazil and worldwide, and ischemic heart disease accounts for a large portion of this concerning scenario. 1 Among its forms of presentation, acute coronary syndrome (ACS) has a wide range of severity. 2 However, the use of validated mathematical models of clinical prediction is essential and recommended in national and international guidelines for the management of patients with ACS. 3,4 With this stratification, high-risk patients may receive more a… Show more
“…Pedro G. M. de Barros e Silva, 1,2,3 Renato D. Lopes 1,2,4 Brazilian Clinical Research Institute, 1 São Paulo, SP -Brazil Hospital Samaritano Paulista, 2 São Paulo, SP -Brazil Centro Universitário São Camilo, 3…”
Section: Risk Scores In Acute Coronary Syndrome: Current Applications...mentioning
“…and wide confidence intervals, the consistency of good discrimination and calibration of this score in different populations reinforces this model as an appropriate tool to estimate the risk of patients with ACS. 2,3 Once a model has shown good performance in estimating risk, it is important to determine if this information may change the clinical practice. Patients with STEMI usually receive a standard level of care and changes in the approach are made more due to complications (e.g.…”
Acute Coronary Syndrome (ACS) is the most common cause of death worldwide. 1 Nevertheless, ACS represents a heterogenous group of diseases, encompassing since low-risk unstable angina (30-day mortality below 1%), until patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (30-day mortality around 50%). Multivariable prediction models have been developed to classify short-term and long-term risk of these patients (Table 1). For patients with the diagnosis of ACS, the TIMI risk score and the Global Registry of Acute Coronary Events (GRACE) score have been largely used in clinical practice; the latter, despite being more complex, has shown better performance as a prognostic tool, including prognostic information not only about the acute phase but also about the risk within six months after the cardiac event. 2 Neves et al., 3 analyzed the performance of GRACE score in 160 patients admitted for ACS in a single center in Brazil. The results corroborate the good discrimination and calibration of GRACE score for in-hospital mortality in the Brazilian population and added information regarding its performance for sixmonth mortality. 3 Despite the limited number of events
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