title: FRISC score for selection of patients for an early invasive treatment strategy in unstable coronary artery disease.
abstract: OBJECTIVE
  To develop a scoring system for risk stratification and evaluation of the effect of an early invasive strategy for treatment of unstable coronary artery disease (CAD).
  
  
  METHODS
  Retrospective analysis of a randomised study (FRISC II; fast revascularisation in instability in coronary disease).
  
  
  METHODS
  58 Scandinavian hospitals.
  
  
  METHODS
  2457 patients with unstable CAD from the FRISC II study.
  
  
  METHODS
  One year rates of mortality and death/myocardial infarction (MI).
  
  
  METHODS
  Patients were randomly assigned to an early invasive or a non-invasive strategy. From the non-invasive cohort independent variables of death or death/MI were identified.
  
  
  RESULTS
  Seven factors, age > 70 years, male sex, diabetes, previous MI, ST depression, and increased concentrations of troponins and markers of inflammation (interleukin 6 or C reactive protein), were associated with an independent increased risk for death or death/MI. In patients with > or = 5 of these factors the invasive strategy reduced mortality from 15.4% (20 of 130) to 5.2% (7 of 134) (risk ratio (RR) 0.34, 95% confidence interval (CI) 0.15 to 0.78, p = 0.006). Death/MI was also reduced in patients with 3-4 factors from 15.7% (80 of 511) to 10.8% (58 of 538) (RR 0.69, 95% CI 0.50 to 0.94, p = 0.02). Neither death nor death/MI was reduced in patients with 0-2 risk factors.
  
  
  CONCLUSIONS
  In unstable CAD, this scoring system based on factors independently associated with an adverse outcome can be used shortly after admission to the hospital for risk stratification and for selection of patients to an early invasive treatment strategy.
authors: Department of Medical Sciences, Cardiology, University Hospital, Uppsala, Sweden. bo.lagerqvist@ucr.uas.lul.se
authors: B
authors: B
authors: Lagerqvist
authors: E
authors: E
authors: Diderholm
authors: B
authors: B
authors: Lindahl
authors: S
authors: S
authors: Husted
authors: F
authors: F
authors: Kontny
authors: E
authors: E
authors: Ståhle
authors: E
authors: E
authors: Swahn
authors: P
authors: P
authors: Venge
authors: A
authors: A
authors: Siegbahn
authors: L
authors: L
authors: Wallentin
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods*; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers