Comparison between Five Risk Scores in Patients with Acute Coronary Syndromes Undergoing Surgical Revascularization...

Area of Science:

• Cardiology
• Clinical Risk Stratification
• Outcomes Research

Background:

• Risk scores (RS) are used for patients with acute coronary syndromes (ACS) and coronary artery bypass grafting (CABG).
• Limited data exists on the utility of these RS for ACS patients undergoing CABG during their initial hospitalization.

Purpose of the Study:

• To compare the predictive performance of five different risk scores in ACS patients undergoing CABG during index hospitalization.
• To evaluate the effectiveness of GRACE, TIMI-NSTEACS, TIMI-STEMI, ACUITY/HORIZONS (A-H) bleeding, and EuroSCORE II.

Main Methods:

• Analysis of 999 patients undergoing CABG between 1998 and 2022.
• Evaluation of risk score performance for in-hospital and long-term mortality (mean follow-up 5.5 years).
• Utilized ROC curves and multivariable analyses to assess predictive accuracy.

Main Results:

• The GRACE score showed the highest area under the ROC curve (0.82) for predicting in-hospital mortality.
• GRACE and TIMI-STEMI were significantly associated with long-term mortality.
• Multivariable analyses confirmed GRACE score as the sole independent predictor of both in-hospital and long-term mortality.

Conclusions:

• The GRACE score is the most effective risk score for predicting in-hospital and long-term mortality in ACS patients undergoing CABG during index hospitalization.
• GRACE demonstrated superior performance in predicting in-hospital deaths compared to other evaluated scores.
• These findings can inform clinical decision-making for this high-risk patient group.