Comparative estimation of prognostic value of the models GRACE, TIMI, PURSUIT in risk stratification of coronary complications in patients with nonST-elevation acute coronary syndrome
The aim of investigation was to held comparative analysis of prognostic value of different models of short-term and long-term cardiovascular risk estimation in patients with non-ST-elevation acute coronary syndrome (ACS). Material and methods. This prospective investigation included 150 patients with non-ST-elevation ACS. During observation estimation of risk complications development level was held with the help of prognostic models GRACE, TIMI, PURSUIT, comparative analysis of predictive possibilities of this models. was held. Results. According to the results of investigation model GRACE demonstrated the most high sensitivity (100%) in prediction of all cause mortality during in-hospital observation. The most high specificity (90%) was marked in prediction of unfavourable outcomes during 6-months observation. TIMI risk stratification model revealed the most high sensitivity (64%), specificity (77%) and predictive accuracy (67%) in prediction of death/myocardial infarction/ischemia during 1-year observation, showed maximal value of positive predictive accuracy during in-hospital period and 12 months of observation in compare with other models. PURSUIT model of cardiovascular risk estimation showed the highest specificity (91%), which was marked in prediction of death/myocardial infarction during next 12 months. High predictive accuracy of this model (91%) related to death/myocardial infarction revealed during 6 months and was maintained during 1-year observation. Conclusion. All systems of risk stratification had high prognostic value, negative predictive accuracy, that is all of them were effective in prognosis of favourable events in patients with non-ST-elevation ACS. GRACE model of risk stratification had maximal sensitivity in prediction of death and death or myocardial infarction during hospitalization and 6-month or 1-year dynamic observation. System of risk stratification TIMI showed maximal value of positive predictive accuracy during in-hospital period and dynamic observation. System of risk stratification PURSUIT demonstrated maximal specificity in prediction of in-hospital, 6-month and 1-year outcomes. Also this model had maximal predictive accuracy related to the prognosis of death and death/myocardial infarction during in-hospital period and 1-year observation.