Predicting freedom from clinical events in non-ST-elevation acute coronary syndromes

摘要

To the editor: We read with interest the paper presented by Brieger et a!' and feel that it is most worthy of comment. The authors describe the development and internal validation of a risk score for patients with non-ST elevation acute coronary syndrome (NSTEACS), from a global registry, that predicts inpatient freedom-from-events. They present an alternative concept to ACS risk characterisation-rather than the identification of high-risk subjects who merit more intensive management, they elect to create a model that can assist healthcare workers identify lower-risk patients who may benefit less from such treatments. They argue that this is important because the discriminative performance of ACS risk scores designed to identify patients at higher risk of adverse outcomes is limited when applied to patients at lower risk of adverse events. We believe that several key points deserve clarification.