ArticleClinical epidemiology2022
A Novel Biomarker Scoring System Alone or in Combination with the GRACE Score for the Prognostic Assessment in Non-ST-Elevation Myocardial Infarction.
Article in Clinical epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 9 citations in OpenAlex.
- Elevated Red Blood Cell Distribution Width Predicts Mortality and Major Adverse Cardiovascular Events After Acute Myocardial Infarction: A Large Propensity Score-Matched Cohort Study.Journal of clinical medicine · 2026Article
- Routine inflammatory indices modify clonal hematopoiesis-related prognostic risk in patients undergoing percutaneous coronary intervention: a real-world cohort study.BMC medicine · 2026Article
- Development and validation of predictive models for prognostic assessment in patients with acute non-ST-segment elevation myocardial infarction: a multicentre real-world study from China.BMC medical informatics and decision making · 2026Article
- A Novel Scale System Based on the Frailty Index and Laboratory Indicators for the Short-Term Prognosis of Patients with Acute Myocardial Infarction: A Retrospective Cohort Study.Clinical interventions in aging · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The Global Registry of Acute Coronary Events (GRACE) score has proven value in predicting short-term prognosis in non-ST-elevation myocardial infarction (NSTEMI), but it has only moderate discrimination for long-term outcomes. The purpose of this study is to develop and test a multi-biomarker score for better risk stratification and indication of 2-year risk in patients with NSTEMI. Patients and Methods: A total of 6076 consecutive patients with NSTEMI (66 [59-73] years, 73.1% males) admitted at Zhongshan Hospital, Fudan University were collected in this observational, prospective study between 2012 and 2018 with a 24-month follow-up. The primary endpoint was all-cause death and non-fatal major adverse cardiac events (MACE). A biomarker score ranged from 0 to 12 was constructed. The predictive power of the biomarker score was evaluated alone or combined with the GRACE score by C-statistic, net reclassification index (NRI) and integrated discrimination index (IDI). Results: During a 2-year follow-up, all-cause death occurred in 159 patients (2.6%), and non-fatal MACEs were presented in 709 patients (11.7%). When added to the GRACE score, the biomarker score demonstrated better prognostic accuracy, patient reclassification and risk discrimination for both mortality and non-fatal MACEs at 2 years by improving the C-statistic from 0.714 (0.671-0.756) and 0.623 (0.600-0.646) to 0.851 (0.820-0.882) and 0.721 (0.702-0.741) with NRI >25% ( Conclusion: The single use of biomarker score could markedly enhance the prognostic value of concurrent risk stratification tools for 2-year mortality and non-fatal MACEs in NSTEMI. The GRACE score with incorporation of the biomarker score led to more accurate risk reclassification and warrants more consideration in further NSTEMI management.
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