Key result
Updated ACTION risk score matches GRACE and CADILLAC for predicting long-term mortality in AMI post-PCI.
Why the study?
The predictive performance of the updated ACTION risk score for long-term mortality in AMI patients undergoing PCI compared to GRACE and CADILLAC risk scores was evaluated.
Does the updated ACTION risk score predict long-term mortality as well as the GRACE and CADILLAC risk scores in patients with AMI undergoing PCI?
Cohort (n=2,629)
Does the updated ACTION risk score predict long-term mortality as well as the GRACE and CADILLAC risk scores in patients with AMI undergoing PCI?
The updated ACTION risk score demonstrates similar discriminatory performance to the established GRACE and CADILLAC risk scores for predicting long-term mortality in AMI patients undergoing PCI.
// Tongtong Yu 1 , Chunyang Tian 1 , Jia Song 1 , Dongxu He 1 , Zhijun Sun 1 and Zhaoqing Sun 1 1 Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R.China Correspondence to: Zhaoqing Sun, email: sunzhaoqing@vip.163.com Keywords: ACTION, risk score, long-term mortality, acute myocardial infarction, percutaneous coronary intervention Received: August 18, 2017 Accepted: September 24, 2017 Published: October 11, 2017 ABSTRACT This study aimed to test the predictive performance of the updated ACTION, GRACE, and CADILLAC risk scores (RS’s) for long-term mortality in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The study included individuals from 2 independent cohorts: derivation cohort ( N = 1901) and validation cohort ( N = 728). From the derivation cohort, we used Cox regression analysis to determine that the updated ACTION, GRACE, and CADILLAC RS’s were associated with long-term mortality. The concordance (C) statistics of the 3 RS’s were 0.682, 0.703 and 0.734, respectively. We used the validation cohort to validate the results. Moreover, the discriminatory performance of the updated ACTION RS for predicting long-term mortality in both the respective derivation and validation cohorts was similar to the discriminatory performance of the GRACE and CADILLAC RS’s (ACTION vs. GRACE: z = 0.684, p = 0.494; ACTION vs. CADILLAC: z = 1.638, p = 0.101) and (ACTION vs. GRACE: z = 0.460, p = 0.646; ACTION vs. CADILLAC: z = 0.290, p = 0.772). Despite their development over a decade ago, GRACE and CADILLAC RS’s maintain good performance for predicting the long-term mortality of AMI patients undergoing PCI. As a new risk model, the updated ACTION RS also predicts long-term mortality, and its discriminatory performance is similar to that of the GRACE and CADILLAC RS’s.
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Yu et al. (2017) conducted a cohort in acute myocardial infarction (AMI) (n=2,629). updated ACTION risk score vs. GRACE and CADILLAC risk scores was evaluated on long-term mortality (C-statistic 0.682, p=0.494). The updated ACTION risk score predicted long-term mortality in AMI patients undergoing PCI (C-statistic 0.682), with similar discriminatory performance to the GRACE and CADILLAC risk scores.
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