TY - JOUR
T1 - Predictive performance of HAS-BLED risk score for long-term survival in patients with non-ST elevated myocardial infarction without atrial fibrillation
AU - Hsieh, Ming Jer
AU - Lee, Cheng Hung
AU - Chen, Chun Chi
AU - Chang, Shang Hung
AU - Wang, Chao Yung
AU - Hsieh, I. Chang
N1 - Publisher Copyright:
© 2016 Japanese College of Cardiology
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background Predictive value of the Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs or alcohol use (HAS-BLED) score for clinical outcomes has been investigated in patients with and without atrial fibrillation. Many factors in the HAS-BLED model have been reported to be prognostic predictors in patients with post-myocardial infarction (MI). However, few studies have investigated the predictive value of HAS-BLED score on long-term survival in patients with post-MI. Methods A total of 617 patients with non-ST elevation MI (NSTEMI) without atrial fibrillation were enrolled. The Thrombolysis In Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), Can Rapid Risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE), and HAS-BLED risk scores were calculated for each patient. Results The C-statistics of TIMI, GRACE, CRUSADE, and HAS-BLED scores for 3-year survival were 0.658, 0.749, 0.756, and 0.765, respectively. For 3-year survival prediction, GRACE, CRUSADE, and HAS-BLED scores, respectively demonstrated superior performance than TIMI score and there was no significant difference between these three scores (GRACE vs. TIMI: z = 1.615, p = 0.027; CRUSADE vs. TIMI: z = 1.371, p = 0.043; HAS-BLED vs. TIMI: z = 1.899, p = 0.014; CRUSADE vs. GRACE: z = 0.078, p = 0.234; HAS-BLED vs. GRACE: z = 0.435, p = 0.166; HAS-BLED vs. CRUSADE: z = 0.353, p = 0.181). Multivariate analysis showed left ventricular ejection fraction <40%, old age, stroke history, bleeding history, and abnormal renal and liver function were independent predictors for 3-year mortality. Conclusions HAS-BLED scoring system is similar to the GRACE and CRUSADE systems but better than TIMI system to predict long-term survival outcomes in patients with NSTEMI without atrial fibrillation. However, HAS-BLED score is easier to calculate than GRACE and CRUSADE scores.
AB - Background Predictive value of the Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs or alcohol use (HAS-BLED) score for clinical outcomes has been investigated in patients with and without atrial fibrillation. Many factors in the HAS-BLED model have been reported to be prognostic predictors in patients with post-myocardial infarction (MI). However, few studies have investigated the predictive value of HAS-BLED score on long-term survival in patients with post-MI. Methods A total of 617 patients with non-ST elevation MI (NSTEMI) without atrial fibrillation were enrolled. The Thrombolysis In Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), Can Rapid Risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE), and HAS-BLED risk scores were calculated for each patient. Results The C-statistics of TIMI, GRACE, CRUSADE, and HAS-BLED scores for 3-year survival were 0.658, 0.749, 0.756, and 0.765, respectively. For 3-year survival prediction, GRACE, CRUSADE, and HAS-BLED scores, respectively demonstrated superior performance than TIMI score and there was no significant difference between these three scores (GRACE vs. TIMI: z = 1.615, p = 0.027; CRUSADE vs. TIMI: z = 1.371, p = 0.043; HAS-BLED vs. TIMI: z = 1.899, p = 0.014; CRUSADE vs. GRACE: z = 0.078, p = 0.234; HAS-BLED vs. GRACE: z = 0.435, p = 0.166; HAS-BLED vs. CRUSADE: z = 0.353, p = 0.181). Multivariate analysis showed left ventricular ejection fraction <40%, old age, stroke history, bleeding history, and abnormal renal and liver function were independent predictors for 3-year mortality. Conclusions HAS-BLED scoring system is similar to the GRACE and CRUSADE systems but better than TIMI system to predict long-term survival outcomes in patients with NSTEMI without atrial fibrillation. However, HAS-BLED score is easier to calculate than GRACE and CRUSADE scores.
KW - CRUSADE
KW - GRACE
KW - HAS-BLED
KW - NSTEMI
KW - Survival
KW - TIMI
UR - http://www.scopus.com/inward/record.url?scp=84959550029&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2016.02.005
DO - 10.1016/j.jjcc.2016.02.005
M3 - 文章
C2 - 26951606
AN - SCOPUS:84959550029
SN - 0914-5087
VL - 69
SP - 136
EP - 143
JO - Journal of Cardiology
JF - Journal of Cardiology
IS - 1
ER -