Abstract | Background: Objectives: To compare and validate different risk scores as predictors of ischemic and bleeding outcomes in AMI patients with ESRD. Methods: This retrospective study enrolled 340 patients who had received percutaneous coronary intervention for AMI while undergoing maintenance hemodialysis for ESRD. Ischemic risk scores (TIMI- STEMI, TIMI- NSTEMI, GRACE, DAPT) and bleeding risk scores (PRECISE- DAPT, CRUSADE, ACUITY, ACTION, SWEDEHEART) were calculated. The ischemic outcome mainly focused on major adverse cardiovascular events (MACEs) within 14 days after hospitalization, and the bleeding outcome was 14-day major bleeding according to the CRUSADE criteria. Results: The GRACE score was superior in discriminating ischemic outcomes, especially in 14-day MACEs [area under curve (AUC) 0.791, p < 0.001]. None of the scores could ideally discriminate 14-day CRUSADE major bleeding, while the PRECISE- DAPT score had the best discriminative power (AUC 0.636, p < 0.001). Either GRACE score > 222 or PRECISE- DAPT score > 48 was associated with higher net adverse cardiovascular events (a composite of 14-day MACEs and 14-day CRUSADE major bleeding). Conclusions: In AMI patients with ESRD, the GRACE score can effectively discriminate the risk of short-term ischemic events. None of the scores could ideally discriminate the bleeding risk, but a high PRECISE- DAPT score still represented a higher rate of bleeding events.
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Authors | Yi-Lin Chen, Tien-Yu Chen, Po-Jui Wu, Wen-Jung Chung, Chien-Ho Lee, Chien-Hao Tseng, Chia-Chen Wu, Chien-Hsing Wu, Cheng-I Cheng |
Journal | Acta Cardiologica Sinica
(Acta Cardiol Sin)
Vol. 38
Issue 6
Pg. 667-682
(Nov 2022)
ISSN: 1011-6842 [Print] China (Republic : 1949- ) |
PMID | 36440245
(Publication Type: Journal Article)
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