Introduction Accurate risk assessment is central to the management of patients presenting with acute coronary syndromes (ACS). Many ACS risk scores are employed as near-point tests, but rely on the collection of remote data such as troponin concentration. This study investigated the long term and short term mortality prediction performance of the Frontal QRS-T Angle and Age Risk (FAAR) score, a simple ACS risk stratification tool comprising of the frontal QRS-T angle and age at admission and compared with GRACE risk score which relies on a multitude of clinical variables.
Method Data from the Evaluation of Methods and Management of Acute Coronary Events EMMACE-2 and EMMACE-1 prospective studies was used to test and validate models respectively. EMMACE studies examined outcomes in consecutively admitted, unselected patients with confirmed ACS in multiple adjacent hospitals (within the catchment area of one tertiary centre) in Yorkshire, UK. Using the EMMACE-2 (2499 patients), FAAR score adjusted for patient characteristics, a stepwise logistic regression and proportional hazards Cox regression models was used to predict 30-day and 2-year mortality.
Results The FAAR score offered excellent discriminative performance for 30-day, C statistic (95% CI) 0.74 (0.71 to 0.78) and 2-year 0.76 (0.74 to 0.78) mortality, maintained its performance in the EMMACE-1 validation cohort at 30-days, C statistic (95% CI) 0.76 (0.71 to 0.80) and at 2-years 0.79 (0.75 to 0.83), and compared favourably with the GRACE score.
Conclusion FAAR score could be used by emergency healthcare professionals to assist the triage of patients presenting with suspected ACS.
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