Comparison of prognostic value of different risk score methods on outcome of acute coronary syndrome

Background Thrombolysis in myocardial infarction (TIMI) flow grade (TFG) was a gold standard for comparison of the various methods of evaluating the efficacy of reperfusion, and risk score was a pragmatic method of risk stratification and evaluation of prognosis for acute coronary syndrome (ACS). However, it is uncertain whether or not the prognostic value of combining risk score and TFG on outcome of acute coronary syndrome could be improved. Materials and Methods A total of 279 consecutive patients with ACS (mean age 67.57 ± 9.88 years, 69.2% male) admitted to our hospital were enrolled. Clinical risk score, TFG, and combined risk score were calculated. The primary endpoint of this study included cardiac death and noncardiac death; the secondary endpoint included nonfatal stroke, reinfarction, heart failure, and recurrent angina. Results During the follow-up of 11.41 ± 5.33 months, 11 patients reached the primary endpoint, and 23 patients reached the secondary endpoint. The prognostic values evaluated by composite endpoint, primary endpoint, and secondary endpoint were 0.722, 0.685, and 0.721, respectively, for clinical risk score they were 0.774, 0.798, and 0.737, respectively, for TFG they were 0.805, 0.808, and 0.776, respectively, for combined risk score. In pair-wise comparisons of prognostic values, there were no significant differences among these methods, except that the combined risk score can more accurately predict the composite endpoint than the others. Conclusion The results suggest that the combined risk score is a simple and efficient method of prediction of composite endpoint. Copyright © 2009 Wiley Periodicals, Inc.