General clinical factors for the development of hemorrhagic events and the application of international prognostic score system in acute coronary syndrome
No 1 (2018), Clinical medicine
No 1 (2018)

General clinical factors for the development of hemorrhagic events and the application of international prognostic score system in acute coronary syndrome

Clinical medicine
https://doi.org/10.31612/2616-4868.1-4.2018.05
Published September 27, 2018
O. Y. Mishcheniuk
State Scientific Institution "Scientific-Practical Centre of Preventive and Clinical Medicine" State Administration of Affairs, Kyiv, Ukraine
O. M. Kostiukevych
State Scientific Institution «Scientific and Practical Center for Preventive and Clinical Medicine» of the State Administration of Department, Kyiv, Ukraine
L. K. Benkovska
State Scientific Institution "Scientific-Practical Centre of Preventive and Clinical Medicine" State Administration of Affairs, Kyiv, Ukraine
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Keywords

hemorrhagic complication, acute coronary syndrome, prognostic score systems

How to Cite

Mishcheniuk, O. Y., Kostiukevych, O. M., & Benkovska, L. K. (2018). General clinical factors for the development of hemorrhagic events and the application of international prognostic score system in acute coronary syndrome. Clinical and Preventive Medicine, (1), 33-41. https://doi.org/10.31612/2616-4868.1-4.2018.05
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Abstract

Objective. The predictive efficiency of the general clinical characteristics of acute coronary syndrome (ACS) patients and International score systems for the development of hemorrhagic complications (HC).

Materials and methods. Results of clinical, clinic-laboratory parameters of 93 patients with ACS, who had been treated at the State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department (2016-2017 y.), were analyzed. The total predictive power (PP) was evaluated using ROC analysis with the area under the curve (AUC). Methods: general clinical, clinic-laboratory, statistical.

Results. Hemorrhagic complications were observed in 22.5 % (21 of 93) ACS patients. In order to assess the probability of HC during the ACS treatment we recommend to take into account the anemia presence (AUC = 0.79; 95 % CI = 0.69-0.86; p < 0.0001), the age over 75 years AUC = 0.76; 95 % CІ = 0.66-0.84; p = 0.0001), the use of triple antithrombotic therapy (TATT) (AUC = 0.87; 95 % CІ = 0.73-0.93; p < 0.0001). Between the score systems, which were analyzed, the highest PP was observed in REPLACE (AUC = 0.88; 95 % CІ = 0.80-0.94; р < 0.0001) and ACUITY (AUC = 0.83; 95 % ДІ = 0.74-0.90; р < 0.0001), which have “very good” predictive efficiency. Instead, the level of efficiency CRUSADE (AUC = 0.78; 95 % CІ = 0.65-0.88; р = 0.0003) and RISK-PCI (AUC = 0.73; 95 % CІ = 0.57-0.86; р = 0.0023) is «good».

Conclusion. It is recommend to take into account the anemia presence, the age over 75 years, TATT for the purpose of the prognosis of HC in ACS. The highest PP was observed in REPLACE and ACUITY that have “very good” predictive efficiency.

https://doi.org/10.31612/2616-4868.1-4.2018.05
ARTICLE PDF (Українська)

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