PURSUIT risk score
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Definition and History
The PURSUIT (Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy) risk score was developed in a randomized clinical trial which recruited 9,461 patients and compared eptifibatide (Integrilin) to placebo in the management of Unstable Angina (UA) or Non-ST elevation Myocardial Infarction (NSTEMI).[1]
Function
- By using multivariate regression analysis, the investigators established seven risk predictors for death and myocardial infarction (MI) in patients with acute coronary syndromes.
- Five of these risk factors were then combined into a scoring system:
- Higher age
- Sex
- Worst Canadian Cardiovascular Society (CCS) class of angina
- Signs of heart failure
- ST-segment depression on the index ECG
- Each of these elements is scored accordingly, resulting in a score ranging 1 - 18.
| Elements | Entry | Score |
|---|---|---|
| Age |
|
|
| Sex |
|
|
| Worst CCS class past 6 weeks |
|
|
| Signs of heart failure |
| |
| ST depression on ECG |
|
Interpretation
- The PURSUIT score predicts the risk of death or death/MI at 30 days after admission.
- ACS patients are divided into low, intermediate, and high risk patients, with suggested therapies of early discharge, watchful waiting, and aggressive antiplatelet / early invasive strategies, respectively.
References
- ↑ Boersma E, Pieper KS, Steyerberg EW, Wilcox RG, Chang WC, Lee KL, Akkerhuis KM, Harrington RA, Deckers JW, Armstrong PW, Lincoff AM, Califf RM, Topol EJ, Simoons ML (June 2000). "Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators". Circulation. 101 (22): 2557–67. doi:10.1161/01.cir.101.22.2557. PMID 10840005.