Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores

Jiachen Luo,1 Liming Dai,1 Jianming Li,2 Jinlong Zhao,1 Zhiqiang Li,1 Xiaoming Qin,1 Hongqiang Li,1 Baoxin Liu,1 Yidong Wei1 1Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Ca...

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Autores principales:	Luo JC, Dai LM, Li JM, Zhao JL, Li ZQ, Qin XM, Li HQ, Liu BX, Wei YD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	myocardial infarction atrial fibrillation GRACE risk score CHA2DS2-VASc score risk evaluation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/1cf84fa5889f4d17be60c07eba43318d
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spelling	oai:doaj.org-article:1cf84fa5889f4d17be60c07eba43318d2021-12-02T01:01:16ZRisk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores1178-1998https://doaj.org/article/1cf84fa5889f4d17be60c07eba43318d2018-06-01T00:00:00Zhttps://www.dovepress.com/risk-evaluation-of-new-onset-atrial-fibrillation-complicating-st-segme-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Jiachen Luo,1 Liming Dai,1 Jianming Li,2 Jinlong Zhao,1 Zhiqiang Li,1 Xiaoming Qin,1 Hongqiang Li,1 Baoxin Liu,1 Yidong Wei1 1Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Cardiovascular Division, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA Purpose: New-onset atrial fibrillation (NOAF) is a common finding in patients with myocardial infarction (MI), but few studies are available regarding the prediction model for its risk estimation. Although Global Registry of Acute Coronary Events (GRACE) risk score (RS) has been recognized as an effective tool for the risk evaluation of clinical outcomes in patients with MI, its usefulness in the prediction of post-MI NOAF remains unclear. In this study, we sought to validate the discrimination performance of GRACE RS in the prediction of post-MI NOAF and to make a comparison with that of the CHA2DS2-VASc score in patients with ST-segment elevation myocardial infarction (STEMI). Patients and methods: A total of 488 patients with STEMI who were admitted to our hospital between May 2015 and October 2016 without a history of atrial fibrillation were retrospectively evaluated in this study. GRACE and CHA2DS2-VASc scores were calculated for each patient. Patients were divided into low (GRACE RS≤125)-, intermediate (GRACE RS 126–154)-, and high (GRACE RS≥155)-risk groups. Receiver operating characteristic curve analyses were performed to evaluate the discrimination performance of both RSs. Model calibration was evaluated by using Hosmer–Lemeshow goodness-of-fit test (HLS). Results: Of the 488 eligible patients, 49 (10.0%) developed NOAF during hospitalization. In the overall cohort, the discrimination performance of GRACE RS (C-statistic: 0.76, 95% CI: 0.72–0.80) was significantly better than that of CHA2DS2-VASc score (C-statistic: 0.68, 95% CI: 0.64–0.72; comparison p=0.03). For subgroup analysis, GRACE RS tended to be better than the CHA2DS2-VASc score in all but the intermediate-risk group as evidenced by C-statistics of 0.60 and 0.65 for GRACE and CHA2DS2-VASc scores, respectively. Excellent calibration was achieved except for GRACE RS in females (HLS p=0.05). Conclusion: The diagnostic performance of GRACE RS is relatively high as well as better than that of the CHA2DS2-VASc score with respect to the prediction of post-MI NOAF. Keywords: myocardial infarction, atrial fibrillation, GRACE risk score, CHA2DS2-VASc score, risk predictionLuo JCDai LMLi JMZhao JLLi ZQQin XMLi HQLiu BXWei YDDove Medical Pressarticlemyocardial infarctionatrial fibrillationGRACE risk scoreCHA2DS2-VASc scorerisk evaluationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1099-1109 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	myocardial infarction atrial fibrillation GRACE risk score CHA2DS2-VASc score risk evaluation Geriatrics RC952-954.6
spellingShingle	myocardial infarction atrial fibrillation GRACE risk score CHA2DS2-VASc score risk evaluation Geriatrics RC952-954.6 Luo JC Dai LM Li JM Zhao JL Li ZQ Qin XM Li HQ Liu BX Wei YD Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
description	Jiachen Luo,1 Liming Dai,1 Jianming Li,2 Jinlong Zhao,1 Zhiqiang Li,1 Xiaoming Qin,1 Hongqiang Li,1 Baoxin Liu,1 Yidong Wei1 1Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Cardiovascular Division, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA Purpose: New-onset atrial fibrillation (NOAF) is a common finding in patients with myocardial infarction (MI), but few studies are available regarding the prediction model for its risk estimation. Although Global Registry of Acute Coronary Events (GRACE) risk score (RS) has been recognized as an effective tool for the risk evaluation of clinical outcomes in patients with MI, its usefulness in the prediction of post-MI NOAF remains unclear. In this study, we sought to validate the discrimination performance of GRACE RS in the prediction of post-MI NOAF and to make a comparison with that of the CHA2DS2-VASc score in patients with ST-segment elevation myocardial infarction (STEMI). Patients and methods: A total of 488 patients with STEMI who were admitted to our hospital between May 2015 and October 2016 without a history of atrial fibrillation were retrospectively evaluated in this study. GRACE and CHA2DS2-VASc scores were calculated for each patient. Patients were divided into low (GRACE RS≤125)-, intermediate (GRACE RS 126–154)-, and high (GRACE RS≥155)-risk groups. Receiver operating characteristic curve analyses were performed to evaluate the discrimination performance of both RSs. Model calibration was evaluated by using Hosmer–Lemeshow goodness-of-fit test (HLS). Results: Of the 488 eligible patients, 49 (10.0%) developed NOAF during hospitalization. In the overall cohort, the discrimination performance of GRACE RS (C-statistic: 0.76, 95% CI: 0.72–0.80) was significantly better than that of CHA2DS2-VASc score (C-statistic: 0.68, 95% CI: 0.64–0.72; comparison p=0.03). For subgroup analysis, GRACE RS tended to be better than the CHA2DS2-VASc score in all but the intermediate-risk group as evidenced by C-statistics of 0.60 and 0.65 for GRACE and CHA2DS2-VASc scores, respectively. Excellent calibration was achieved except for GRACE RS in females (HLS p=0.05). Conclusion: The diagnostic performance of GRACE RS is relatively high as well as better than that of the CHA2DS2-VASc score with respect to the prediction of post-MI NOAF. Keywords: myocardial infarction, atrial fibrillation, GRACE risk score, CHA2DS2-VASc score, risk prediction
format	article
author	Luo JC Dai LM Li JM Zhao JL Li ZQ Qin XM Li HQ Liu BX Wei YD
author_facet	Luo JC Dai LM Li JM Zhao JL Li ZQ Qin XM Li HQ Liu BX Wei YD
author_sort	Luo JC
title	Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
title_short	Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
title_full	Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
title_fullStr	Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
title_full_unstemmed	Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores
title_sort	risk evaluation of new-onset atrial fibrillation complicating st-segment elevation myocardial infarction: a comparison between grace and cha2ds2-vasc scores
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/1cf84fa5889f4d17be60c07eba43318d
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Risk evaluation of new-onset atrial fibrillation complicating ST-segment elevation myocardial infarction: a comparison between GRACE and CHA2DS2-VASc scores

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