Prospective validation of the Dante Pazzanese risk score in non-ST-segment elevation acute coronary syndrome.

BACKGROUND

In non-ST-segment elevation acute coronary syndrome (ACS), the likelihood of adverse events should be estimated. Guidelines recommend risk stratification models for that purpose. The Dante Pazzanese risk score (DANTE score) is a simple risk stratification model composed with the following variables: age increase (0 to 9 points); history of diabetes mellitus (2 points) or stroke (4 points); no use of angiotensin-converting-enzyme inhibitor (1 point); creatinine elevation (0 to 10 points); combination of troponin elevation and ST-segment depression (0 to 4 points).

OBJECTIVE

To validate the DANTE score in patients with non-ST-segment elevation ACS.

METHODS

Prospective, observational study including 457 patients, from September 2009 to October 2010. The patients were grouped in risk categories according to the original model score as follows: very low; low; intermediate; and high. The predictive ability of the score was assessed by using C-statistics.

RESULTS

The sample comprised 291 (63.7%) men, the mean age being 62.1 years (SD=11.04). The event death or (re)infarction in 30 days was observed in 17 patients (3.7%). Progressive increase in the proportion of events was observed as the score increased: very low risk = 0.0%; low risk = 3.9%; intermediate risk = 10.9%; high risk = 60.0%; p < 0.0001. C-statistics was 0.87 (95% CI: 0.81-0.94; p < 0.0001).

CONCLUSION

DANTE score showed an excellent capacity to predict the specific events, and can be incorporated to the prognostic assessment of patients with non-ST-segment elevation ACS.