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    GRACE score predicts heart failure admission following acute coronary syndrome

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    Authors
    McAllister, David A.
    Halbesma, Nynke
    Carruthers, Kathryn F.
    Denvir, Martin
    Fox, Keith A.
    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2014-07-01
    Keywords
    heart failure
    myocardial infarction
    prognosis
    Cardiology
    Cardiovascular Diseases
    Clinical Epidemiology
    Epidemiology
    Health Services Research
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1177/2048872614542724
    Abstract
    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
    10.1177/2048872614542724
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27188
    PubMed ID
    24986419
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1177/2048872614542724
    Scopus Count
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