Use of Risk Scoring Tools to Determine Risk of Secondary Cardiac and Non-Cardiac Events During Hospitalization for ST Elevation Myocardial Infarction in a Cohort of Women

Thursday, 2 August 2012: 3:15 PM

Elizabeth Ann Scruth, RN, MN, MPH
Department of Quality and Regulatory Services, Kaiser Permanente, Oakland, CA
Eugene Cheng, MD
Critical Care, Kaiser Permanente, San Jose, CA
Linda Worrall-Carter, RN, BEd, PhD
Nursing Research, St Vincent's/ACU Center for Nursing Research, Melbourne, Australia

Learning Objective 1: 1. The learner will be able to describe cardiovascular risk scoring tools used to determine secondary risk of events in Acute Coronary Syndrome patients.

Learning Objective 2: 2. The learner will be able to describe the use of cardiovascular risk scoring tools to assist with determination of treatment strategies.


 GRACE, TIMI and CADILLAC are risk scores designed for predicting short term outcomes after acute coronary syndromes. The aim of our study was to test their utility for prediction of a secondary major cardiac and non cardiac event in a cohort of women treated invasively for an ST Elevation Myocardial Infarction.


Our sample size consisted of consecutive patients with ST Elevation Myocardial Infarction treated with primary percutaneous coronary intervention. A retrospective approach was utlized.


In general the CADILLAC, TIMI and GRACE risk scores all had relatively high predictive accuracy for major cardiac events in hospital, with C statistics ranging from 0.63 to 0.718 with the CADILLAC risk score being the highest . For major non cardiac events in hospital the three risk scores were similar in accuracy with C statistics ranging from 0.62 to 0.66.


Risk stratification of patients with STEMI undergoing primary percutaneous coronary intervention using the CADILLAC, GRACE or TIMI risk score provides important prognostic information and enables identification of high risk patients. Utilization of the risk scores will aid in determinng treatment strategies and care post intervention.