Comparative Analysis Of Three Ischemic Risk Score For Predicting Prognosis In Patients With Acute Coronary Syndrome

Objective: This paper aims to assess risk score (including GRACE, TIMI andPURSUIT) prognostic significance for patients with ACS, and explore what risk score topredict the short and long term prognosis of higher value，For clinicians to select forclinical prognostic risk score to provide a referenceMethods: A retrospective analysis of652cases from December2011to March2013in our hospital Cardiology clinical data of hospitalized patients with ACS,Average age:62years old，Sex ratio：Male65.8%, Unstable angina,36%of which,Non-ST segment elevation myocardial infarction by46%，ST segment elevationmyocardial infarction by18%。Patients were followed up during hospitalization andafter discharge cases major adverse cardiovascular events (Major adversecardiovascular events, MACE) occurred in1year.The clinical characteristics of patientswith risk factors and laboratory examinations indicators MACE univariate analysisoffspring into Logistic regression analysis, independent screening MACE Collectedclinical variables GRACE calculated according to each patient’s admission, TIMI riskscore and the PURSUIT be grouped，Analysis of the relationship between differentgroups of patients during hospitalization and one year with the risk of occurrence ofcardiovascular events between the scores，Compare the predictive value ofcardiovascular events in patients with the ability to identify the occurrence of eachrating system within30days and1year of onset。Area (Area under curve, AUC) depictsthree risk score of the receiver operating characteristic curve (Area under the receiver-operating characteristic curve, ROC) curves and calculations, the risk score werecompared in three patients during hospitalization and1year the predictive value of the rateof MACE.Results：1follow-up during hospitalization occurred MACE38patients (5.8%), ofwhich6deaths (0.9%);1year after discharge recurrence MACE70patients (10.7%), ofwhich12patients died (1.8%).2.GRACE, TIMI and PURSUIT risk score, the higher the incidence of MACEduring hospitalization, there MACE rate for each risk score between the groups wassignificant difference (P=0.001,0.026,0.003).3.GRACE, TIMI risk score and the PURSUIT ACS patients can be predicted riskof MACE, GRACE risk score to predict the value of MACE during hospitalization maximum(AUC0.702), MACE PURSUIT, and TIMI risk score occurred during hospitalization and has agood predictive value, but lower than the GRACE score (AUC, respectively0.633,0.621)4. GRACE score for ACS patients discharged from a year MACE rate is still highpredictive value (P=0.002), PURSUIT, and TIMI risk score predicted no statisticalsignificance (P=0.041, P=0.171).5This study shows: ACS patients hospitalized during my hospital MACEincidence of5.8%, the findings and CPACS (5.8%) is consistent，However, the incidence ofMACE was discharged a year rate of11.4%, compared with CPACS results (8.4%) hadsignificantly higher，The results from the statistical analysis of which75.7%occurred in theGRACE score-high-risk patients,67%did not revascularization line. Conclusions:1.GRACE, TIMI risk score and the PURSUIT of MACE occurred duringhospitalization in patients with ACS have better predictive value, which MACE eventsGRACE score for the highest sensitivity and specificity.2.GRACE risk score for one year outside the hospital MACE also betterpredictive value occurs PURSUIT score lower TIMI score and clinical value.3.GRACE risk score to occur outside the hospital during hospitalizationand1year maximum predicted value of MACE can be used as the preferred clinicalprognostic risk score, TIMI score and PURSUIT score could be used as supplementaryshort-term prognosis.4single-center analysis according to the hospital, discharged a yearhigher MACE rate, it should be emphasized as the score for GRACE-Early revascularizationin high-risk patients and the need to adhere to the system after discharge medications andregular follow-up, reducing the long-term MACE events.