Assessment of the prognostic value of the CRUSADE score in Algerian patients with NSTE-ACS treated with an invasive approach

Abstract

The CRUSADE score was created for assessment of bleeding risk in patients with acute coronary syndrome (ACS). However, its accuracy was not confirmed in populations of patients treated in Algerian hospitals. To examine the value of CRUSADE bleeding score in predicting bleeding events in patients with NSTE-ACS managed invasively. Our study included 296 patients with NSTE-ACS. They underwent history and clinical examination; 12-lead electrocardiography; echocardiography; coronarography, troponin T us; hematocrit value; estimated glomerular filtration rate (eGFR); application of CRUSADE score; and a one year follow-up with documentations of events. Patients were classified into two groups: Group I: patients with major bleeding (BARC ≥ 3), and Group II: patients without major bleeding. Sixteen (5.4%) patients had a major bleeding events, seven (2.4%) during the initial in-hospital period and nine (3%) during the follow-up after discharge. Patients with major bleeding events were significantly older (69 ± 12 vs.61 ± 12 years, P = 0.024), with more diabetic (9.3% vs. 1.9%, P = 0.008), lower hematocrit (34.1 ± 5.3% vs.40.2 ± 5.2%, P < 0.0001), lower eGFR (65.6 ± 32.4 mL/min vs.85.2 ± 36.4 mL/min, P = 0.036), and higher CRUSADE risk score. Crusade score measurement in patients with major bleeding was significantly higher than in those without coronary artery disease (36.9 ± 14.1 vs. 27.1 ± 13.1; P = 0.004). CRUSADE bleeding score was the strongest predictor of major bleeding. Sensitivity of CRUSADE score ≥ 38 in prediction of major bleeding in the whole study group was 62.5%, specificity was 79.6%, and overall accuracy was 70.0%. CRUSADE score is a good predictor for one-year major bleeding events in Algerian patients with NSTE-ACS treated with an invasive approach.