Risk stratification

Quality Statement 4

A patient with a non-ST-segment-elevation acute coronary syndrome (NSTEACS) is managed based on a documented, evidence-based assessment of their risk of an adverse event.

Purpose

To assess the risk of an adverse event and provide appropriate therapy to patients with an NSTEACS.

For consumers

If you have a heart attack in which the artery supplying an area of the heart muscle is partly but not fully blocked, your treatment will depend on your risk of having a serious heart problem in the future. Your doctor will discuss your individual level of risk with you, and work with you to make sure you have the information you need to make choices about your treatment.

For clinicians

Use an evidence-based risk assessment tool to stratify the patient’s risk of future cardiac events. Discuss the identified level of risk with the patient, and use a shared decision making process to plan their treatment based on their risk of an adverse event and their treatment preferences. 

Risk assessment tools include: 

  • GRACE ACS Risk Calculator1
  • TIMI Risk Score for UA/NSTEMI2
  • Decision making and timing considerations in reperfusion for STEMI.3

 

References: 

  1. GRACE Centre for Outcomes Research. Global Registry of Acute Coronary Events [Internet]. Boston (MA): University of Massachusetts Medical School; 2019 [cited 2019 Apr 11]. Available from: www.outcomes-umassmed.org/grace
  2. Antman EM. TIMI risk score for UA/NSTEMI 2019 [Internet]. MDCalc; 2019 [cited 2019 Mon dd]. Available from: www.mdcalc.com/timi-risk-score-ua-nstemi
  3. National Heart Foundation of Australia (NHFA). Decision-making and timing considerations in reperfusion for STEMI. NHFA; 2016.

For health service organisations

Ensure that an evidence-based risk assessment process is available to guide the treatment of all patients with an NSTEACS, and that clinicians use it consistently.

For consumers

If you have a heart attack in which the artery supplying an area of the heart muscle is partly but not fully blocked, your treatment will depend on your risk of having a serious heart problem in the future. Your doctor will discuss your individual level of risk with you, and work with you to make sure you have the information you need to make choices about your treatment.

For clinicians

Use an evidence-based risk assessment tool to stratify the patient’s risk of future cardiac events. Discuss the identified level of risk with the patient, and use a shared decision making process to plan their treatment based on their risk of an adverse event and their treatment preferences. 

Risk assessment tools include: 

  • GRACE ACS Risk Calculator1
  • TIMI Risk Score for UA/NSTEMI2
  • Decision making and timing considerations in reperfusion for STEMI.3

 

References: 

  1. GRACE Centre for Outcomes Research. Global Registry of Acute Coronary Events [Internet]. Boston (MA): University of Massachusetts Medical School; 2019 [cited 2019 Apr 11]. Available from: www.outcomes-umassmed.org/grace
  2. Antman EM. TIMI risk score for UA/NSTEMI 2019 [Internet]. MDCalc; 2019 [cited 2019 Mon dd]. Available from: www.mdcalc.com/timi-risk-score-ua-nstemi
  3. National Heart Foundation of Australia (NHFA). Decision-making and timing considerations in reperfusion for STEMI. NHFA; 2016.

For health service organisations

Ensure that an evidence-based risk assessment process is available to guide the treatment of all patients with an NSTEACS, and that clinicians use it consistently.

Read Quality Statement 5 - Coronary angiography