Comparison of prognostic value of risk assessment scores in patients with myocardial infarction

Aim. To compare the prognostic value of the PRECISE-DAPT, the GRACE 2.0 and the CRUSADE scores and estimate their potential for detecting ischemic and hemorrhagic events within 2 years after ST-elevated myocardial infarction (MI).

Methods. 680 registry patients enrolled in the Kemerovo Acute Coronary Syndrome Registry in 2015 were retrospectively reviewed. Individual risks were calculated according to the PRECISE-DAPT, the GRACE 2.0 and the CRUSADE scores for each patient. The subgroups with the highest risk were allocated for the subsequent assessment. The following retrospective endpoints (deaths, strokes, MI, unstable angina (UA), heart failure (HF), major bleedings) were collected for two years to perform a comparative analysis of the prognostic value of the PRECISE-DAPT score, the GRACE 2.0 score and the CRUSADE to evaluate their prognostic potential to predict hemorrhagic and ischemic events.

Results. Similar rates of strokes (р = 0.530), MI (р = 0.107), UA (р = 0.099) and major bleedings (р = 0.190) in the outpatient settings were found among patients with calculated PRECISE-DAPT and GRACE 2.0 scores. However, PRECISE-DAPT score predicted a smaller number of deaths (р = 0.001) and HF decompensations (р = 0.048). Similar rates of major bleedings (р = 0.714), UA (р = 0.515), MI (р = 0,522), and strokes (р = 0.230) were found between the PRECISE-DAPT score and the CRUSADE score. However, the former was inferior in terms of the incidence of HF decompensations (р = 0.041).

Conclusion. The retrospective comparative study on the sample of MI patients enrolled in the Kemerovo Acute Coronary Syndrome Registry confirmed similar prognostic potential of the PRECISE-DaPt score, the GRACE 2.0 and the CRUSADE scores for predicting a two-year outcome in the outpatient settings.

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