![]() The Optimal Vasopressor Titration (ovation) Pilot Randomized Controlled Trial.The Efficacy and Safety of Varenicline, a Selective Alpha4beta2 Nicotinic Receptor Partial Agonist, for Smoking Cessation in Patients Hospitalized With Acute Coronary Syndrome: A Randomized Controlled Trial.Risk Stratification Of The Toronto Ards Cohort Using Recover Program Disability Groups.The Impact of Smoking on Clinical Outcomes and the Role of Double-Dose versus Standard-Dose Clopidogrel Among Individuals With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention -Insights From the CURRENTOASIS 7 Trial.Parallel Pilot Screening Frequency Trials In elderly And Nonelderly Critically ill Patients.Īmerican Journal of Respiratory and Critical Care Medicine.Important prognostic factors like anaemia, C-reactive protein, extent of CAD, left ventricular ejection fraction (LVEF), and so on, are not included in any of the above systems. Each of these scoring systems has avoided some factors. Nonetheless, the authors should be congratulated for an excellent study and this should encourage other hospitals to adopt risk scoring system while dealing with patients of ACS.ĭespite the availability of these above composite risk scores one cannot get away from the fact that there is a need for more inclusive risk scoring systems. Also, the impact of revascularisation on prognosis and correlation with GRACE score is not clear. There is no information on whether ejection fraction (EF) has any correlation with GRACE score. Is it the financial capacity of the patients? A slightly greater number of patients have undergone coronary angiography among patients with lower GRACE score. The exact basis for choosing patients for coronary angiogram is not clear. They also found a good correlation between GRACE score and extent of coronary artery disease (CAD) at angiography. A GRACE risk score of 217 has emerged as a good cut-off point of risk stratification. All other variables of GRACE risk score have shown excellent correlation. The increase in heart rate tended to show a correlation with risk but it was not statistically significant. Only one patient had cardiac arrest at presentation, hence this factor could not be assessed. Their study has clearly validated most of the risk markers of GRACE score. They have applied GRACE risk score to a cohort of patients which included ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). This group of authors has well established credentials for clinical research. John's Medical College and Hospital is a large tertiary care hospital which caters predominantly to low and middle-class population. John's Medical College and Hospital, Bengaluru have presented the clinical data of 235 patients of ACS and attempted validation of GRACE risk score. In this issue of Indian Heart Journal, Prabhudesai et al. There was a significant interaction between the benefit of myocardial revascularisation during initial hospitalisation and the extent of risk evaluated by GRACE and PURSUIT scores. They have clearly demonstrated that GRACE score was the best in predicting the risk of death or MI at 1 year after admission. 7 They have looked at short-term as well as long-term mortality. from Portugal have applied the three scoring systems TIMI, GRACE, and PURSUIT to the same group of 460 patients admitted to a single centre. In an interesting study published in European Heart Journal, Gonçalves et al. ACS: acute coronary syndrome, BP: blood pressure, CCS: Canadian Cardiovascular Society, ECG: electrocardiogram, GRACE: Global Registry of Acute Coronary Events, TIMI: thrombolysis in myocardial infarction. ![]()
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