title: Validation of the Canada Acute Coronary Syndrome Risk Score for Hospital Mortality in the Gulf Registry of Acute Coronary Events-2.
abstract: BACKGROUND
  Several risk scores have been developed for acute coronary syndrome (ACS) patients, but their use is limited by their complexity. The new Canada Acute Coronary Syndrome (C-ACS) risk score is a simple risk-assessment tool for ACS patients. This study assessed the performance of the C-ACS risk score in predicting hospital mortality in a contemporary Middle Eastern ACS cohort.
  
  
  OBJECTIVE
  The C-ACS score accurately predicts hospital mortality in ACS patients.
  
  
  METHODS
  The baseline risk of 7929 patients from 6 Arab countries who were enrolled in the Gulf RACE-2 registry was assessed using the C-ACS risk score. The score ranged from 0 to 4, with 1 point assigned for the presence of each of the following variables: age ≥75 years, Killip class >1, systolic blood pressure <100 mm Hg, and heart rate >100 bpm. The discriminative ability and calibration of the score were assessed using C statistics and goodness-of-fit tests, respectively.
  
  
  RESULTS
  The C-ACS score demonstrated good predictive values for hospital mortality in all ACS patients with a C statistic of 0.77 (95% confidence interval [CI]: 0.74-0.80) and in ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome patients (C statistic: 0.76, 95% CI: 0.73-0.79; and C statistic: 0.80, 95% CI: 0.75-0.84, respectively). The discriminative ability of the score was moderate regardless of age category, nationality, and diabetic status. Overall, calibration was optimal in all subgroups.
  
  
  CONCLUSIONS
  The new C-ACS score performed well in predicting hospital mortality in a contemporary ACS population outside North America.
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hussam F
authors.initials: HF
authors.lastname: AlFaleh
authors.affiliation: College of Medicine, Mohammed bin Rashid University of Medicine and health sciences, Dubai, United Arab Emirates.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Anhar
authors.initials: A
authors.lastname: Ullah
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Khalid F
authors.initials: KF
authors.lastname: AlHabib
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hersi
authors.affiliation: Department of Cardiology, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Jassim Al
authors.initials: JA
authors.lastname: Suwaidi
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.affiliation: Cardiology Department, Saud Al Babtain Cardiac Center, Dammam, Saudi Arabia.
authors.forename: Shukri Al
authors.initials: SA
authors.lastname: Saif
authors.affiliation: Department of Cardiology, Heart and vascular institute Cleveland clinic Abu Dhabi, United Arab Emirates.
authors.forename: Wael
authors.initials: W
authors.lastname: Almahmeed
authors.affiliation: Department of Cardiology, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.affiliation: Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain.
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
authors.affiliation: Department of Cardiology, Sana's University, Sana'a, Yemen.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Motarreb
authors.affiliation: Department of Cardiac Sciences, King Fahad Cardiac Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Tarek
authors.initials: T
authors.lastname: Kashour
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality*; D000328:Adult; D000368:Aged; D018912:Arabs; D003661:Decision Support Techniques; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D011237:Predictive Value of Tests; D012042:Registries; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors