Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population
Risk stratification is essential in managing patients with non-ST-elevation myocardial infarction (NSTEMI). While multiple risk scores exist, their validation in developing countries like India remains limited. This study compares the predictive accuracy of the PURSUIT, HEART, TIMI, GRACE 2.0, and...
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PAGEPress Publications
2025-07-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/macd/article/view/3386 |
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| author | Ruchi Sharma Bhushan Shah Sumit Verma Vijay Pathak Sunil Sharma Pradeep Meena Shekhar Kunal |
| author_facet | Ruchi Sharma Bhushan Shah Sumit Verma Vijay Pathak Sunil Sharma Pradeep Meena Shekhar Kunal |
| author_sort | Ruchi Sharma |
| collection | DOAJ |
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Risk stratification is essential in managing patients with non-ST-elevation myocardial infarction (NSTEMI). While multiple risk scores exist, their validation in developing countries like India remains limited. This study compares the predictive accuracy of the PURSUIT, HEART, TIMI, GRACE 2.0, and CAMI-NSTEMI scores for major adverse cardiovascular events (MACE), including death, non-fatal myocardial infarction, emergency percutaneous coronary intervention, and coronary artery bypass grafting, in NSTEMI patients. This was a single-center prospective observational study wherein patients diagnosed with NSTEMI were enrolled. Detailed clinical histories, including symptomatology and risk factors, were recorded. Five risk scores (TIMI, GRACE 2.0, PURSUIT, HEART, and CAMI-NSTEMI scores) were computed. Outcomes were assessed for in-hospital, 14-day, six-month, and one-year MACE. A total of 1102 patients were enrolled, with a mean age of 59.6±11.2 years. MACE occurred in 140 patients (12.7%), with 89 deaths (8.1%). Patients with MACE were older and more likely to smoke or have hypertension, diabetes, or stroke. Multivariate logistic regression analysis identified angina in the last 48 hours, diabetes, smoking, cardiac arrest, and fragmented QRS on electrocardiogram as independent MACE predictors. TIMI showed the highest predictive ability for in-hospital MACE, while GRACE excelled for 14-day, 6-month, and 1-year outcomes. All risk scores effectively predicted short- and intermediate-term MACE, with GRACE performing best for longer-term predictions.
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| format | Article |
| id | doaj-art-e01f2e0bf81540808d2434a923ed376e |
| institution | Kabale University |
| issn | 1122-0643 2532-5264 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj-art-e01f2e0bf81540808d2434a923ed376e2025-08-20T03:31:15ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642025-07-0110.4081/monaldi.2025.3386Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian populationRuchi Sharma0Bhushan Shah1https://orcid.org/0000-0002-8716-3448Sumit Verma2https://orcid.org/0000-0002-9577-7845Vijay Pathak3Sunil Sharma4Pradeep Meena5Shekhar Kunal6https://orcid.org/0000-0002-0319-9241Department of Cardiology, Employees' State Insurance Corporation Medical College and Hospital, Faridabad, HaryanaDepartment of Cardiology, All India Institute of Medical Sciences, Bhopal, Madhya PradeshDepartment of Cardiology, Sawai Man Singh Medical College, JaipurDepartment of Cardiology, Sawai Man Singh Medical College, JaipurDepartment of Cardiology, Sawai Man Singh Medical College, JaipurDepartment of Cardiology, Sawai Man Singh Medical College, JaipurDepartment of Cardiology, Employees' State Insurance Corporation Medical College and Hospital, Faridabad, Haryana Risk stratification is essential in managing patients with non-ST-elevation myocardial infarction (NSTEMI). While multiple risk scores exist, their validation in developing countries like India remains limited. This study compares the predictive accuracy of the PURSUIT, HEART, TIMI, GRACE 2.0, and CAMI-NSTEMI scores for major adverse cardiovascular events (MACE), including death, non-fatal myocardial infarction, emergency percutaneous coronary intervention, and coronary artery bypass grafting, in NSTEMI patients. This was a single-center prospective observational study wherein patients diagnosed with NSTEMI were enrolled. Detailed clinical histories, including symptomatology and risk factors, were recorded. Five risk scores (TIMI, GRACE 2.0, PURSUIT, HEART, and CAMI-NSTEMI scores) were computed. Outcomes were assessed for in-hospital, 14-day, six-month, and one-year MACE. A total of 1102 patients were enrolled, with a mean age of 59.6±11.2 years. MACE occurred in 140 patients (12.7%), with 89 deaths (8.1%). Patients with MACE were older and more likely to smoke or have hypertension, diabetes, or stroke. Multivariate logistic regression analysis identified angina in the last 48 hours, diabetes, smoking, cardiac arrest, and fragmented QRS on electrocardiogram as independent MACE predictors. TIMI showed the highest predictive ability for in-hospital MACE, while GRACE excelled for 14-day, 6-month, and 1-year outcomes. All risk scores effectively predicted short- and intermediate-term MACE, with GRACE performing best for longer-term predictions. https://www.monaldi-archives.org/macd/article/view/3386Acute coronary syndromemyocardial infarctioncardiovascular riskscardiovascular mortality |
| spellingShingle | Ruchi Sharma Bhushan Shah Sumit Verma Vijay Pathak Sunil Sharma Pradeep Meena Shekhar Kunal Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population Monaldi Archives for Chest Disease Acute coronary syndrome myocardial infarction cardiovascular risks cardiovascular mortality |
| title | Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population |
| title_full | Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population |
| title_fullStr | Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population |
| title_full_unstemmed | Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population |
| title_short | Risk stratification in non-ST-elevation myocardial infarction: evaluating the predictive accuracy of various risk scores in an Indian population |
| title_sort | risk stratification in non st elevation myocardial infarction evaluating the predictive accuracy of various risk scores in an indian population |
| topic | Acute coronary syndrome myocardial infarction cardiovascular risks cardiovascular mortality |
| url | https://www.monaldi-archives.org/macd/article/view/3386 |
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