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The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome
BACKGROUND: The prognosis of Takotsubo syndrome (TTS) is comparable to that of the non-ST-elevation myocardial infarction (NSTEMI). The GRACE scale is used to assess the risk of premature and long-term mortality in patients with NSTEMI in order to select the most favorable treatment strategy. METHOD...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197005/ https://www.ncbi.nlm.nih.gov/pubmed/32405274 http://dx.doi.org/10.1155/2020/4340930 |
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author | Zalewska-Adamiec, Malgorzata Kuzma, Lukasz Dobrzycki, Slawomir Bachorzewska-Gajewska, Hanna |
author_facet | Zalewska-Adamiec, Malgorzata Kuzma, Lukasz Dobrzycki, Slawomir Bachorzewska-Gajewska, Hanna |
author_sort | Zalewska-Adamiec, Malgorzata |
collection | PubMed |
description | BACKGROUND: The prognosis of Takotsubo syndrome (TTS) is comparable to that of the non-ST-elevation myocardial infarction (NSTEMI). The GRACE scale is used to assess the risk of premature and long-term mortality in patients with NSTEMI in order to select the most favorable treatment strategy. METHODS: 101 patients with TTS hospitalized in four centers of invasive cardiology in Podlaskie Voivodeship during the period 2008–2012 were included in the study. The patients were divided into two groups: I—52 patients (GRACE ≤ 140 points) and II—49 patients (GRACE > 140 points). RESULTS: The mean GRACE score in the study group was 138.66. The in-hospital stay of Takotsubo in the patients with higher GRACE scores was associated with higher incidence of pneumonia (36.7% vs 7.69%, p=0.0004), rhythm abnormalities (17.3% vs 3.85%, p=0.026), and serious complications (cardiogenic shock, pulmonary edema, and sudden cardiac arrest) (30.6% vs 5.77%, p=0.001). The mean observation period was 7.2 years. A significantly higher risk of 6-month (18.37% vs 3.85%, p=0.019), 1-year (22.45 vs 3.85%, p=0.005), 3-year (40.82 vs 3.85%, p < 0.0001), 5-year (42.86% vs 3.85%, p < 0.0001), and 7-year mortalities (53.06% vs 9.62%, p < 0.0001) was observed in the group of patients with a GRACE score ≥140. At multivariate analysis including low BMI, low eGFR, and a higher GRACE score, all these factors were independent predictor of death (p=0.042; p=0.010; p=0.041). The ROC curve presents the discriminatory scores of the GRACE scale for the follow-up prognostication. The area under ROC curve (AUC) for the GRACE scale was 0.805 (95% CI: 0.718–0.892, p < 0.0001), with a cut-off value of 153 points, sensitivity of 74%, and specificity of 77% for TTS. CONCLUSION: The GRACE scale is highly valuable for the prognostication of death risk in patients with TTS in the early and long-term observation. |
format | Online Article Text |
id | pubmed-7197005 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-71970052020-05-13 The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome Zalewska-Adamiec, Malgorzata Kuzma, Lukasz Dobrzycki, Slawomir Bachorzewska-Gajewska, Hanna J Interv Cardiol Research Article BACKGROUND: The prognosis of Takotsubo syndrome (TTS) is comparable to that of the non-ST-elevation myocardial infarction (NSTEMI). The GRACE scale is used to assess the risk of premature and long-term mortality in patients with NSTEMI in order to select the most favorable treatment strategy. METHODS: 101 patients with TTS hospitalized in four centers of invasive cardiology in Podlaskie Voivodeship during the period 2008–2012 were included in the study. The patients were divided into two groups: I—52 patients (GRACE ≤ 140 points) and II—49 patients (GRACE > 140 points). RESULTS: The mean GRACE score in the study group was 138.66. The in-hospital stay of Takotsubo in the patients with higher GRACE scores was associated with higher incidence of pneumonia (36.7% vs 7.69%, p=0.0004), rhythm abnormalities (17.3% vs 3.85%, p=0.026), and serious complications (cardiogenic shock, pulmonary edema, and sudden cardiac arrest) (30.6% vs 5.77%, p=0.001). The mean observation period was 7.2 years. A significantly higher risk of 6-month (18.37% vs 3.85%, p=0.019), 1-year (22.45 vs 3.85%, p=0.005), 3-year (40.82 vs 3.85%, p < 0.0001), 5-year (42.86% vs 3.85%, p < 0.0001), and 7-year mortalities (53.06% vs 9.62%, p < 0.0001) was observed in the group of patients with a GRACE score ≥140. At multivariate analysis including low BMI, low eGFR, and a higher GRACE score, all these factors were independent predictor of death (p=0.042; p=0.010; p=0.041). The ROC curve presents the discriminatory scores of the GRACE scale for the follow-up prognostication. The area under ROC curve (AUC) for the GRACE scale was 0.805 (95% CI: 0.718–0.892, p < 0.0001), with a cut-off value of 153 points, sensitivity of 74%, and specificity of 77% for TTS. CONCLUSION: The GRACE scale is highly valuable for the prognostication of death risk in patients with TTS in the early and long-term observation. Hindawi 2020-04-24 /pmc/articles/PMC7197005/ /pubmed/32405274 http://dx.doi.org/10.1155/2020/4340930 Text en Copyright © 2020 Malgorzata Zalewska-Adamiec et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Zalewska-Adamiec, Malgorzata Kuzma, Lukasz Dobrzycki, Slawomir Bachorzewska-Gajewska, Hanna The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title | The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title_full | The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title_fullStr | The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title_full_unstemmed | The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title_short | The GRACE Scale in the Prognosis of Patients with Takotsubo Syndrome |
title_sort | grace scale in the prognosis of patients with takotsubo syndrome |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197005/ https://www.ncbi.nlm.nih.gov/pubmed/32405274 http://dx.doi.org/10.1155/2020/4340930 |
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