ABC | Volume 113, Nº1, July 2019

Short Editorial Timóteo ProACS risk score Arq Bras Cardiol. 2019; 113(1):31-32 1. Collins GS, Reitsma JB, Altman DG, Moons KG. Transparent Reporting of a multivariate prediction model for individual Prognosis or Diagnosis (TRIPOD): the TRIPOD statement. Ann Intern Med. 2015;162(1):55-63. 2. Eichler K, Zoller M, Tschudi P, Steurer J. Barriers to apply cardiovascular prediction rules in primary care: a postal survey. BMC Fam Pract. 2007 Jan 3;8:1 3. Gil J, Abreu L, Antunes H, GonçalvesML, PiresMI, Santos LF, et al. Aplicação de escores de risco em síndromes coronárias agudas: como o ProACS se comporta diante de outros escores de risco? Arq Bras Cardiol. 2019; 113(1):20-30 4. Timoteo AT, Aguiar Rosa S, Afonso Nogueira M, Belo A, Cruz Ferreira R, ProACS Investigators. ProACS risk score: an early and simple score for risk stratification in patients with acute coronary syndromes. Rev Port Cardiol. 2017;36(2):77-83. 5. Timoteo AT, Mimoso J, em nome dos investigadores do Registo Nacional de Síndromes Coronárias Agudas. Portuguese Registry of Acute Coronary Syndromes (ProACS): 15 years of a continuous and prospective registry. Rev Port Cardiol. 2018;37(7):563-73. 6. Timoteo AT, Aguiar Rosa S, Nogueira MA, Belo A, Cruz Ferreira R. External validation of the ProACS score for stratification of patients with acute coronary syndromes. Rev Port Cardiol. 2016;35(6):323-8. 7. HuynhT,KouzS,YanAT,DanchinN,O’LoughlinJ,SchamparetE,etal.Canada AcuteCoronarySyndromeRiskScore:anewriskscoreforearlyprognostication in acute coronary syndromes. AmHeart J. 2013;166(1):58-63. References This is an open-access article distributed under the terms of the Creative Commons Attribution License The main objective of ProACS risk score is to immediately stratify the risk in patients with ACS to decide on the adequate management and thus its main objective is the short-term outcome. Results in longer-term follow up were not adequate. For long-term outcome, the inclusion of other variables, such as renal function, troponins and others are also important. What should not be forgotten is that for each risk stratification score, impact studies should also be performed after external validation. In fact, external validity does not mean that beneficial clinical effects will be obtained when we use a risk score and it does not give information regarding the possible adverse events. Impact studies are essential and should be studied separately from development and validation, preferably in randomized clinical trials and they are usually not performed. From the above, researchers should spend more time on validation and assessing the impact of existing models instead of developing more models that will most likely never be used in clinical practice. This should be the next step to definitely support the use of ProACS risk score in clinical practice. From the results presented in this study, ProACS risk score will probably be soon implemented in clinical practice, due to the easy and simple application in clinical practice and high discrimination presented but impact studies are needed. 32