Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients
Introduction. The ability of risk models to predict in-hospital mortality and the influence on downstream therapeutic strategy has not been fully investigated in Chinese Non-ST-segment elevation myocardial infarction (NSTEMI) patients. Thus, we sought to validate and compare the performance of the G...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/2469281 |
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| _version_ | 1832568545351827456 |
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| author | Peng Wang Hongliang Cong Ying Zhang Yujie Liu |
| author_facet | Peng Wang Hongliang Cong Ying Zhang Yujie Liu |
| author_sort | Peng Wang |
| collection | DOAJ |
| description | Introduction. The ability of risk models to predict in-hospital mortality and the influence on downstream therapeutic strategy has not been fully investigated in Chinese Non-ST-segment elevation myocardial infarction (NSTEMI) patients. Thus, we sought to validate and compare the performance of the Global Registry of Acute Coronary Events risk model (GRM) and China Acute Myocardial Infarction risk model (CRM) and investigate impacts of the two models on the selection of downstream therapeutic strategies among these patients. Methods. We identified 2587 consecutive patients with NSTEMI. The primary endpoint was in-hospital death. For each patient, the predicted mortality was calculated according to GRM and CRM, respectively. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow (H–L) test, and net reclassification improvement (NRI) were used to assess the performance of models. Results. In-hospital death occurred in 4.89% (126/2587) patients. Compared to GRM, CRM demonstrated a larger AUC (0.809 versus 0.752, p<0.0001), less discrepancy between observed and predicted mortality (H–L χ2: 22.71 for GRM, p=0.0038 and 10.25 for CRM, p=0.2479), and positive NRI (0.3311, p<0.0001), resulting in a significant change of downstream therapeutic strategy. Conclusion. In Chinese NSTEMI patients, the CRM provided a more accurate estimation for in-hospital mortality, and application of the CRM instead of the GRM changes the downstream therapeutic strategy remarkably. |
| format | Article |
| id | doaj-art-0a3a98b0cbf94e9f86edccd864272783 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-0a3a98b0cbf94e9f86edccd8642727832025-02-03T00:58:43ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/24692812469281Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction PatientsPeng Wang0Hongliang Cong1Ying Zhang2Yujie Liu3Tianjin Medical University, Tianjin, ChinaTianjin Medical University, Tianjin, ChinaTianjin Medical University, Tianjin, ChinaTianjin Medical University, Tianjin, ChinaIntroduction. The ability of risk models to predict in-hospital mortality and the influence on downstream therapeutic strategy has not been fully investigated in Chinese Non-ST-segment elevation myocardial infarction (NSTEMI) patients. Thus, we sought to validate and compare the performance of the Global Registry of Acute Coronary Events risk model (GRM) and China Acute Myocardial Infarction risk model (CRM) and investigate impacts of the two models on the selection of downstream therapeutic strategies among these patients. Methods. We identified 2587 consecutive patients with NSTEMI. The primary endpoint was in-hospital death. For each patient, the predicted mortality was calculated according to GRM and CRM, respectively. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow (H–L) test, and net reclassification improvement (NRI) were used to assess the performance of models. Results. In-hospital death occurred in 4.89% (126/2587) patients. Compared to GRM, CRM demonstrated a larger AUC (0.809 versus 0.752, p<0.0001), less discrepancy between observed and predicted mortality (H–L χ2: 22.71 for GRM, p=0.0038 and 10.25 for CRM, p=0.2479), and positive NRI (0.3311, p<0.0001), resulting in a significant change of downstream therapeutic strategy. Conclusion. In Chinese NSTEMI patients, the CRM provided a more accurate estimation for in-hospital mortality, and application of the CRM instead of the GRM changes the downstream therapeutic strategy remarkably.http://dx.doi.org/10.1155/2020/2469281 |
| spellingShingle | Peng Wang Hongliang Cong Ying Zhang Yujie Liu Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients Cardiology Research and Practice |
| title | Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients |
| title_full | Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients |
| title_fullStr | Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients |
| title_full_unstemmed | Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients |
| title_short | Comparison of the CAMI-NSTEMI and GRACE Risk Model for Predicting In-Hospital Mortality in Chinese Non-ST-Segment Elevation Myocardial Infarction Patients |
| title_sort | comparison of the cami nstemi and grace risk model for predicting in hospital mortality in chinese non st segment elevation myocardial infarction patients |
| url | http://dx.doi.org/10.1155/2020/2469281 |
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