Use of clinical risk stratification systems in patients with ACS
Current American College of Cardiology/American Heart Association Guidelines recommend the application of a validated early risk assessment model to determine whether an early invasive or conservative treatment strategy should be selected for patients with suspected ACS. The TIMI (Thrombolysis in Myocardial Infarction), PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy), and GRACE (Global Registry of Acute Cardiac Events) risk stratification models incorporate both clinical and demographic characteristics, and are commonly applied in the triage and therapeutic decision-making process for patients presenting with chest discomfort. In this review, the derivation, components, and prognostic value of each risk score are summarized and compared. In addition, potential biomarkers that may be incorporated into future risk models are discussed.
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