Comparison of the seven-year predictive value of six risk scores in acute coronary syndrome patients: GRACE, TIMI STEMI, TIMI NSTEMI, SIMPLE, ZWOLLE and BANACH

Kardiol Pol. 2014;72(2):155-65. doi: 10.5603/KP.a2013.0216. Epub 2013 Aug 30.

Abstract

Background and aim: To compare the long-term predictive value of six risk scores in a seven-year follow-up of acute coronary syndrome (ACS) patients.

Methods: We followed 906 patients diagnosed with ACS for seven years prospectively. The following risk scores (RS) were calculated: TIMI STEMI, TIMI NSTEMI, GRACE, SIMPLE, ZWOLLE and BANACH. Based on the survival data, the predictive value for each RS was calculated with receiver operating characteristics (ROC) curve analysis and presented as area under curve (AUC).

Results: The seven-year survival was 71%. The RS showed diverse long-term predictive values and AUC. The best estimation was demonstrated by the TIMI STEMI (0.779 [95% CI 0.743-0.812]), GRACE RS (0.766 [95% CI 0.737-0.794]) and BANACHRS (0.743 [95% CI 0.713-0.771]). Other scores presented were SIMPLE (0.714 [95% CI 0.683-0.743], TIMI NSTEMI (0.635 [95% CI 0.580-0.688]) and ZWOLLE (0.739 [95% CI 0.697-0.779].

Conclusions: The predictive values of currently recommended RSs are good for long-term perspective (seven years). RSs with high usability, such as BANACH RS, demonstrate accuracy similar to the more advanced RS.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests*
  • Prognosis
  • Risk Assessment / methods*
  • Risk Assessment / statistics & numerical data*
  • Risk Factors
  • Time Factors
  • Young Adult