| Improving long-term risk prediction in patients with acute chest pain: the Global Registry of Acute Coronary Events (GRACE) risk score is enhanced by selected nonnecrosis biomarkers. | |
| | |
MedLine Citation:
|
PMID: 20598977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The Global Registry of Acute Coronary Events (GRACE) risk score is widely recommended for risk assessment in patients with acute coronary syndrome. However, there is limited knowledge regarding the utility of this score for long-term risk prediction in unselected patients with acute chest pain and whether it might be improved by the integration of nonnecrosis biomarkers. METHODS: We calculated the GRACE risk score in 453 chest pain patients and assessed its value for risk assessment together with the additive prognostic information obtained from N-terminal pro-B-type natriuretic peptide, C-reactive protein, growth differentiation factor-15 (GDF-15), and cystatin C. RESULTS: After a median follow-up of 5.8 years, 92 patients (20.7%) had died. The GRACE risk score was significantly higher in patients who died (median 146 vs 93, P < .001) and provided a c-statistic regarding mortality of 0.78. A significant increase of the c-statistic was achieved only after addition of GDF-15 (c-statistic 0.81, P = .003) and, to a minor extent, after addition of cystatin C (c-statistic 0.81, P = .035). Assessment of the integrated discriminative improvement yielded similar results. N-terminal pro-B-type natriuretic peptide had only limited incremental prognostic value, and C-reactive protein was not predictive for outcome. CONCLUSION: The GRACE risk score allows for the prediction of mortality in chest pain patients even after almost 6 years of follow-up. However, its predictive value could be further enhanced by the addition of selected nonnecrosis biomarkers, in particular GDF-15 or cystatin C. |
| | |
Authors:
|
Kai M Eggers; Tibor Kempf; Per Venge; Lars Wallentin; Kai C Wollert; Bertil Lindahl |
Related Documents
:
|
1353977 - Coronary "open" endarterectomy and reconstruction: short- and long-term results of the ... 12947207 - Collateral formation in patients after percutaneous myocardial revascularization: a mec... 20538117 - Difference in patient profiles and outcomes in japanese versus american patients underg... 10781277 - Jugular venous bulb oxygen saturation in patients with preexisting diabetes mellitus or... 18998287 - Comparative study of morbidity and mortality associated with nondescent vaginal hystere... 2273117 - Microbiologic counts during outpatient office-based cutaneous surgery. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: American heart journal Volume: 160 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-05 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
|
Languages: eng Pagination: 88-94 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright (c) 2010 Mosby, Inc. All rights reserved. |
Affiliation:
|
Department of Medical Sciences, Cardiology, Uppsala University Hospital and Uppsala Clinical Research Center, Uppsala, Sweden. kai.eggers@ucr.uu.se |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Coronary Syndrome
/
blood,
complications*,
epidemiology Aged Aged, 80 and over Biological Markers / blood C-Reactive Protein / metabolism* Chest Pain / diagnosis*, epidemiology, etiology Coronary Care Units Disease Progression Electrocardiography Female Follow-Up Studies Growth Differentiation Factor 15 / blood Humans Male Middle Aged Natriuretic Peptide, Brain / blood* Necrosis / blood Peptide Fragments / blood* Prevalence Prognosis Protein Precursors Registries* Retrospective Studies Risk Assessment / methods* Risk Factors Salivary Cystatins / blood Severity of Illness Index Sweden / epidemiology Time Factors Troponin I / blood* |
| Chemical | |
Reg. No./Substance:
|
0/Biological Markers; 0/Growth Differentiation Factor 15; 0/Peptide Fragments; 0/Protein Precursors; 0/Salivary Cystatins; 0/Troponin I; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Gender differences in time to presentation for myocardial infarction before and after a national wom...
Next Document: Chronic obstructive pulmonary disease after myocardial infarction in the community.