The China Acute Myocardial Infarction risk model (CRM) demonstrated a larger AUC than the GRACE risk model (0.809 vs 0.752, p<0.0001) for predicting in-hospital mortality in Chinese NSTEMI patients.
Observational (n=2,587)
Does the China Acute Myocardial Infarction risk model (CRM) improve prediction of in-hospital mortality compared to the GRACE risk model in Chinese NSTEMI patients?
The CRM provides a more accurate estimation of in-hospital mortality than the GRACE risk model in Chinese NSTEMI patients, potentially altering downstream therapeutic strategies.
Effect estimate: AUC 0.809 vs 0.752
p-value: p=<0.0001
Introduction . The ability of risk models to predict in-hospital mortality and the influence on downstream therapeutic strategy has not been fully investigated in Chinese Non-ST-segment elevation myocardial infarction (NSTEMI) patients. Thus, we sought to validate and compare the performance of the Global Registry of Acute Coronary Events risk model (GRM) and China Acute Myocardial Infarction risk model (CRM) and investigate impacts of the two models on the selection of downstream therapeutic strategies among these patients. Methods . We identified 2587 consecutive patients with NSTEMI. The primary endpoint was in-hospital death. For each patient, the predicted mortality was calculated according to GRM and CRM, respectively. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow (H–L) test, and net reclassification improvement (NRI) were used to assess the performance of models. Results . In-hospital death occurred in 4.89% (126/2587) patients. Compared to GRM, CRM demonstrated a larger AUC (0.809 versus 0.752, p0.0001), less discrepancy between observed and predicted mortality (H–L χ 2 : 22.71 for GRM, p=0.0038 and 10.25 for CRM, p=0.2479), and positive NRI (0.3311, p0.0001), resulting in a significant change of downstream therapeutic strategy. Conclusion . In Chinese NSTEMI patients, the CRM provided a more accurate estimation for in-hospital mortality, and application of the CRM instead of the GRM changes the downstream therapeutic strategy remarkably.
Wang et al. (Fri,) conducted a observational in Non-ST-segment elevation myocardial infarction (NSTEMI) (n=2,587). China Acute Myocardial Infarction risk model (CRM) vs. Global Registry of Acute Coronary Events risk model (GRM) was evaluated on In-hospital death (AUC 0.809 vs 0.752, p=<0.0001). The China Acute Myocardial Infarction risk model (CRM) demonstrated a larger AUC than the GRACE risk model (0.809 vs 0.752, p<0.0001) for predicting in-hospital mortality in Chinese NSTEMI patients.