Menu
×
West Ashley Library
Closed for Staff Day
Phone: (843) 766-6635
Wando Mount Pleasant Library
Closed for Staff Day
Phone: (843) 805-6888
Village Library
Closed for Staff Day
Phone: (843) 884-9741
St. Paul's/Hollywood Library
Closed for Staff Day
Phone: (843) 889-3300
Otranto Road Library
Closed for Staff Day
Phone: (843) 572-4094
Mt. Pleasant Library
Closed for Staff Day
Phone: (843) 849-6161
McClellanville Library
Closed for Staff Day
Phone: (843) 887-3699
Keith Summey North Charleston Library
Closed for Staff Day
Phone: (843) 744-2489
John's Island Library
Closed for Staff Day
Phone: (843) 559-1945
Hurd/St. Andrews Library
Closed for Staff Day
Phone: (843) 766-2546
Folly Beach Library
Closed for Staff Day
Phone: (843) 588-2001
Dorchester Road Library
Closed for Staff Day
Phone: (843) 552-6466
John L. Dart Library
Closed for Staff Day
Phone: (843) 722-7550
Baxter-Patrick James Island
Closed for Staff Day
Phone: (843) 795-6679
Main Library
Closed for Staff Day
Phone: (843) 805-6930
Bees Ferry West Ashley Library
Closed for Staff Day
Phone: (843) 805-6892
Miss Jane's Building (Edisto Library Temporary Location)
Closed
Phone: (843) 869-2355
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Today's Hours
West Ashley Library
Closed for Staff Day
Phone: (843) 766-6635
Wando Mount Pleasant Library
Closed for Staff Day
Phone: (843) 805-6888
Village Library
Closed for Staff Day
Phone: (843) 884-9741
St. Paul's/Hollywood Library
Closed for Staff Day
Phone: (843) 889-3300
Otranto Road Library
Closed for Staff Day
Phone: (843) 572-4094
Mt. Pleasant Library
Closed for Staff Day
Phone: (843) 849-6161
McClellanville Library
Closed for Staff Day
Phone: (843) 887-3699
Keith Summey North Charleston Library
Closed for Staff Day
Phone: (843) 744-2489
John's Island Library
Closed for Staff Day
Phone: (843) 559-1945
Hurd/St. Andrews Library
Closed for Staff Day
Phone: (843) 766-2546
Folly Beach Library
Closed for Staff Day
Phone: (843) 588-2001
Dorchester Road Library
Closed for Staff Day
Phone: (843) 552-6466
John L. Dart Library
Closed for Staff Day
Phone: (843) 722-7550
Baxter-Patrick James Island
Closed for Staff Day
Phone: (843) 795-6679
Main Library
Closed for Staff Day
Phone: (843) 805-6930
Bees Ferry West Ashley Library
Closed for Staff Day
Phone: (843) 805-6892
Miss Jane's Building (Edisto Library Temporary Location)
Closed
Phone: (843) 869-2355
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Patron Login
menu
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
Sex-specific evaluation and redevelopment of the GRACE score in non-ST-segment elevation acute coronary syndromes in populations from the UK and Switzerland: a multinational analysis with external cohort validation.
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
- Author(s): Wenzl, Florian A (AUTHOR); Kraler, Simon (AUTHOR); Ambler, Gareth (AUTHOR); Weston, Clive (AUTHOR); Herzog, Sereina A (AUTHOR); Räber, Lorenz (AUTHOR); Muller, Olivier (AUTHOR); Camici, Giovanni G (AUTHOR); Roffi, Marco (AUTHOR); Rickli, Hans (AUTHOR); Fox, Keith A A (AUTHOR); de Belder, Mark (AUTHOR); Radovanovic, Dragana (AUTHOR); Deanfield, John (AUTHOR); Lüscher, Thomas F (AUTHOR)
- Source:
Lancet. Sep2022, Vol. 400 Issue 10354, p744-756. 13p. - Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- Abstract:
Background: The Global Registry of Acute Coronary Events (GRACE) 2.0 score was developed and validated in predominantly male patient populations. We aimed to assess its sex-specific performance in non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and to develop an improved score (GRACE 3.0) that accounts for sex differences in disease characteristics.Methods: We evaluated the GRACE 2.0 score in 420 781 consecutive patients with NSTE-ACS in contemporary nationwide cohorts from the UK and Switzerland. Machine learning models to predict in-hospital mortality were informed by the GRACE variables and developed in sex-disaggregated data from 386 591 patients from England, Wales, and Northern Ireland (split into a training cohort of 309 083 [80·0%] patients and a validation cohort of 77 508 [20·0%] patients). External validation of the GRACE 3.0 score was done in 20 727 patients from Switzerland.Findings: Between Jan 1, 2005, and Aug 27, 2020, 400 054 patients with NSTE-ACS in the UK and 20 727 patients with NSTE-ACS in Switzerland were included in the study. Discrimination of in-hospital death by the GRACE 2.0 score was good in male patients (area under the receiver operating characteristic curve [AUC] 0·86, 95% CI 0·86-0·86) and notably lower in female patients (0·82, 95% CI 0·81-0·82; p<0·0001). The GRACE 2.0 score underestimated in-hospital mortality risk in female patients, favouring their incorrect stratification to the low-to-intermediate risk group, for which the score does not indicate early invasive treatment. Accounting for sex differences, GRACE 3.0 showed superior discrimination and good calibration with an AUC of 0·91 (95% CI 0·89-0·92) in male patients and 0·87 (95% CI 0·84-0·89) in female patients in an external cohort validation. GRACE 3·0 led to a clinically relevant reclassification of female patients to the high-risk group.Interpretation: The GRACE 2.0 score has limited discriminatory performance and underestimates in-hospital mortality in female patients with NSTE-ACS. The GRACE 3.0 score performs better in men and women and reduces sex inequalities in risk stratification.Funding: Swiss National Science Foundation, Swiss Heart Foundation, Lindenhof Foundation, Foundation for Cardiovascular Research, and Theodor-Ida-Herzog-Egli Foundation. [ABSTRACT FROM AUTHOR]
Contact CCPL
Copyright 2022 Charleston County Public Library Powered By EBSCO Stacks 3.3.0 [350.3] | Staff Login
No Comments.