Prospective validation of the Dante Pazzanese risk score in non-ST-segment elevation acute coronary syndrome

Arq Bras Cardiol. 2013 Sep;101(3):197-204. doi: 10.5935/abc.20130163. Epub 2013 Aug 14.
[Article in English, Portuguese]

Abstract

Background: In non-ST-segment elevation acute coronary syndrome (ACS), the likelihood of adverse events should be estimated. Guidelines recommend risk stratification models for that purpose. The Dante Pazzanese risk score (DANTE score) is a simple risk stratification model composed with the following variables: age increase (0 to 9 points); history of diabetes mellitus (2 points) or stroke (4 points); no use of angiotensin-converting-enzyme inhibitor (1 point); creatinine elevation (0 to 10 points); combination of troponin elevation and ST-segment depression (0 to 4 points).

Objective: To validate the DANTE score in patients with non-ST-segment elevation ACS.

Methods: Prospective, observational study including 457 patients, from September 2009 to October 2010. The patients were grouped in risk categories according to the original model score as follows: very low; low; intermediate; and high. The predictive ability of the score was assessed by using C-statistics.

Results: The sample comprised 291 (63.7%) men, the mean age being 62.1 years (SD=11.04). The event death or (re)infarction in 30 days was observed in 17 patients (3.7%). Progressive increase in the proportion of events was observed as the score increased: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; high risk = 60.0%; p < 0.0001. C-statistics was 0.87 (95% CI: 0.81-0.94; p < 0.0001).

Conclusion: DANTE score showed an excellent capacity to predict the specific events, and can be incorporated to the prognostic assessment of patients with non-ST-segment elevation ACS.

Publication types

  • Validation Study

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Adult
  • Age Factors
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Brazil
  • Creatinine / blood
  • Diabetes Mellitus
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Risk Assessment* / methods
  • Stroke / complications
  • Time Factors
  • Troponin / blood

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Troponin
  • Creatinine