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Predictive Impact on Medium-Term Mortality of Hematological Parameters in Acute Coronary Syndromes: Added Value on Top of GRACE Risk Score

2015-04Journal article Open access
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dc.contributor.authorTimóteo, AT
dc.contributor.authorPapoila, AL
dc.contributor.authorLousinha, A
dc.contributor.authorAlves, M
dc.contributor.authorMiranda, F
dc.contributor.authorFerreira, ML
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2017-06-09T12:13:38Z
dc.date.available2017-06-09T12:13:38Z
dc.date.issued2015-04
dc.description.abstractBACKGROUND: Red Cell Distribution Width (RDW) prognostic value in patients with Acute Coronary Syndrome (ACS) has been well validated whereas that of Platelet Distribution Width (PDW) is less well known. OBJECTIVES: Investigate the incremental prognostic value, on top of GRACE risk score, of a new variable resulting from the combination of RDW and PDW. METHODS: Consecutive patients with ACS. Complete blood count, with RDW and PDW, was obtained. Primary endpoint was one-year all-cause mortality and Cox regression models were used to measure the influence of RDW and PDW on patients' survival time. A new combination categorical variable (RDW/PDW) was created with both discretized RDW and PDW and logistic regression models were used. Predictive value and discriminative ability of the model with GRACE risk score alone and of the model with inclusion of RDW/PDW was assessed. RESULTS: We included 787 patients. Hospital and one-year mortality rates were 5.1% and 7.8%, respectively. Both continuous RDW and PDW were independent predictors of death. The best cut-off for RDW was 13.9%, and 14.5% for PDW. Inclusion of RDW/PDW in a model with GRACE risk score improved the AUC from 0.81 (95% CI 0.75-0.86) to 0.84 (95% CI 0.79-0.90) (p=0.024) with an improvement in total NRI (56%) and IDI (0.048). CONCLUSIONS: Simple markers such as RDW and PDW can be useful in risk stratification of death after ACS. Combining both markers with GRACE risk score improved the predictive value for all-cause mortality and reduced the estimated risk of those who did not die.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur Heart J Acute Cardiovasc Care. 2015 Apr;4(2):172-9pt_PT
dc.identifier.doi10.1177/2048872614547690pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2707
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectAgedpt_PT
dc.subjectBiomarkerspt_PT
dc.subjectBlood Cell Countpt_PT
dc.subjectCohort Studiespt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectIntensive Care Unitspt_PT
dc.subjectMalept_PT
dc.subjectMathematical Computingpt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMyocardial Infarctionpt_PT
dc.subjectPortugalpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSensitivity and Specificitypt_PT
dc.subjectErythrocyte Indicespt_PT
dc.subjectPlatelet Countpt_PT
dc.subjectHSM CARpt_PT
dc.subjectCHLC CINVpt_PT
dc.subjectCHLC PAT CLINpt_PT
dc.titlePredictive Impact on Medium-Term Mortality of Hematological Parameters in Acute Coronary Syndromes: Added Value on Top of GRACE Risk Scorept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage179pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage172pt_PT
oaire.citation.titleEuropean Heart Journal: Acute Cardiovascular Carept_PT
oaire.citation.volume4pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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