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Comparison of Cadillac Risk Score and GRACE Risk Score to Predict In-Hospital Major Adverse Cardiac Events in Post Primary Percutaneous Coronary Intervention Patients

Author : A. A. Asrial, A. Pudjiastuti, Haryadi, L. Raharjoyo, N. Virginia, Y. Herry
Upload Date : 19-04-2018

Background: Several risk scores (RS) have been developed in order to stratify ST-Elevation Myocardial Infarction (STEMI) patients according to their risk of mortality or complications. CADILLAC RS was created from primary percutaneous coronary intervention (PPCI) patients and completely combined clinical, procedural and left ventricular ejection fraction (LVEF) variables. In the other side GRACE RS was created only from clinical variable upon admission but developed based on large registry cohort for the entire spectrum of acute coronary syndromes. Aim of our study was to compare CADILLAC risk score and GRACE RS to predict in hospital major adverse cardiac events (MACE).

Methods: A retrospective study was conducted by medical record, catheterization laboratory and echocardiography laboratory data. GRACE RS and CADILLAC RS were calculated for every patient. In-hospital MACE was defined as any death, lethal arrhythmia, stroke or re-infarction during hospitalization.

Results: The study population consisted of 50 patients. Average patients age were 52.9 ± 10.6 years old with average LVEF 45.56 ± 11.88 % and most of them were male (90%). During in-hospital period, 5 (10%) patients experienced adverse events (1 ischemic stroke, 1 ventricular tachycardia/fibrillation and 3 deaths). Patients with in-hospital adverse event had lower creatinine clearance level (42.91±16.11 vs 54.48±21.92;0=0.036) and were mostly diabetic (80% vs 24.44% ; p=0.04). From AUC ROC analysis, the GRACE RS (0.820;95% CI , 0.697-0.943) had better predictive value than CADILLAC RS (0.717 ;95% CI, 0.572-0.862). Our study was consistent with other studies that GRACE RS had better predictive value compared with others.

Conclussion: GRACE RS had better predictive value than CADILLAC RS to predict in-hospital MACE in post PPCI patients.

KEYWORDS : GRACE RS, CADILLAC RS, in-hospital MACE, STEMI, primary PCI


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