Pooled analysis of validations studies showed c-statistics of 0.54 (95% CI = 0.52-0.57) and 0.67 (95% CI = 0.62-0.71) for short and long term TIMI validation studies, and 0.83 (95% CI = 0.79-9.87) and 0.80 (95% CI = 0.74-0.89) for short and long term GRACE studies. For NSTEMI/UA, 18 derivation studies with 56,560 patients and 18 validation cohorts with 56,673 patients were included. Pooled analysis of GRACE scores, both at short (0.82 0.80-0.89 I.C 95%) and long term follow up (0.84 0.82-0.87 I.C 95%) showed the best performance, with similar results to Simple Risk Index (SRI) derivation cohorts at short term. 7 derivation studies with 25,525 ACS patients and 15 validation studies including 257,654 people were formally appraised. The c-statistics of validation studies were pooled when appropriate with random-effect methods. They were divided into ACS studies (evaluating Unstable Angina UA, Non ST Segment Elevation Myocardial Infarction NSTEMI, and ST Segment Elevation Myocardial Infarction STEMI), UA/NSTEMI studies or STEMI studies. PubMed was systematically searched for ACS risk score studies. ![]() Risk scores have become the cornerstone in clinical and interventional decision making. Acute coronary syndromes (ACS) represent a difficult challenge for physicians.
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