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GRACE score predicts heart failure admission following acute coronary syndrome
UMass Chan Affiliations
Center for Outcomes ResearchDocument Type
Journal ArticlePublication Date
2014-07-01Keywords
heart failuremyocardial infarction
prognosis
Cardiology
Cardiovascular Diseases
Clinical Epidemiology
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Congestive heart failure (CHF) is a common and preventable complication of acute coronary syndrome (ACS). Nevertheless, ACS risk scores have not been shown to predict CHF risk. We investigated whether the at-discharge Global Registry of Acute Coronary Events (GRACE) score predicts heart failure admission following ACS. METHODS AND RESULTS: Five-year mortality and hospitalization data were obtained for patients admitted with ACS from June 1999 to September 2009 to a single centre of the GRACE registry. CHF was defined as any admission assigned WHO International Classification of Diseases 10 diagnostic code I50. The hazard ratio (HR) for CHF according to GRACE score was estimated in Cox models adjusting for age, gender and the presence of CHF on index admission. Among 1,956 patients, CHF was recorded on index admission in 141 patients (7%), and 243 (12%) were admitted with CHF over 3.8 median years of follow-up. Compared to the lowest quintile, patients in the highest GRACE score quintile had more CHF admissions (116 vs 17) and a shorter time to first admission (1.2 vs 2.0 years, HR 9.87, 95% CI 5.93-16.43). Per standard deviation increment in GRACE score, the instantaneous risk was more than two-fold higher (HR 2.28; 95% CI 2.02-2.57), including after adjustment for CHF on index admission, age and gender (HR 2.49; 95% CI 2.06-3.02). The C-statistic for CHF admission at 1-year was 0.74 (95% CI 0.70-0.79). CONCLUSIONS: The GRACE score predicts CHF admission, and may therefore be used to target ACS patients at high risk of CHF with clinical monitoring and therapies.Source
McAllister DA, Halbesma N, Carruthers K, Denvir M, Fox KA. GRACE score predicts heart failure admission following acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2014 Jul 1. doi:10.1177/2048872614542724 [Epub ahead of print]DOI
10.1177/2048872614542724Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27188PubMed ID
24986419Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1177/2048872614542724