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1、EuropeanHeartJournal(2005)26,865–872doi:10.1093/eurheartj/ehi187ClinicalresearchTIMI,PURSUIT,andGRACEriskscores:sustainedprognosticvalueandinteractionwithrevascularizationinNSTE-ACSPedrodeArau′joGonc?alves*,JorgeFerreira,CarlosAguiar,andRicardoSeabra-Gomes1Cardiolo

2、gyDepartment,SantaCruzHospital,Av.Prof.Dr.ReinaldodosSantos,2790-134,Carnaxide,PortugalReceived21November2004;revised24January2005;accepted27January2005;onlinepublish-ahead-of-print11March2005Seepage851fortheeditorialcommentonthisarticle(doi:10.1093/eurheartj/ehi21

3、4)KEYWORDSAimsRegardingprognosis,patientswithanon-STelevationacutecoronarysyndromeTIMIriskscore;(ACS)areaveryheterogeneouspopulation,withvaryingrisksofearlyandlong-termPURSUITriskscore;adverseevents.Earlyriskstrati?cationatadmissionseemstobeessentialforatai-GRACEri

4、skscore;loredtherapeuticstrategy.WesoughttocomparetheprognosticvalueofthreeACSCoronarydisease;riskscores(RSs)andtheirabilitytopredictbene?tfrommyocardialrevascularizationMyocardialinfarction;performedduringinitialhospitalization.Unstableangina;MethodsandresultsWest

5、udied460consecutivepatientsadmittedtoourcoronaryPrognosis;careunitwithanACS[age:63+11years,21.5%female,55%withmyocardialinfarc-Riskstrati?cationtion(MI)].Foreachpatient,theThrombolysisInMyocardialInfarction(TIMI),PlateletglycoproteinIIb/IIIainUnstableagina:Receptor

6、SuppressionUsingIntegrilin(PURSUIT),andGlobalRegistryofAcuteCoronaryEvents(GRACE)RSswerecalculatedusingspeci?cvariablescollectedatadmission.TheirprognosticvaluewasevaluatedbythecombinedendpointofdeathorMIat1year.Thebestcut-offvalueforeachRS,calculatedwithreceiverop

7、eratingcharacteristiccurves,wasusedtoassesstheimpactofmyocardialrevascularizationonthecombinedincidenceofdeathorMI.DeathorMIat1yearwas15.4%(32deaths/49MIs).ThebestpredictiveaccuracyfordeathorMIat1yearwasobtainedbytheGRACERS(AUC)[areaunderthecurve:0.715;con?denceint

8、erval(CI:0.672–0.756)]buttheperformanceofthePURSUITRS(AUC:0.630;CI:0.584–0.674),andTIMIRS(AUC:0.585;CI:0.539–0.631)wasalsogood.Wefoundastatistica