Clinical Association among GRACE score and SYNTAX score in Non ST Elevation Acute Coronary Syndrome patients

Abstract

INTRODUCTION: American College of Cardiology, American Heart Association, and the European Society of Cardiology advocate utilization of variety of risk assessment tools for assessment of ischemia. ^{1, 2}

OBJECTIVE: To find association among GRACE and SYNTAX scores in acute coronary syndrome individuals excluding STEMI.

METHADOLOGY: This research was carried out in Cardiology Department of Central Park Teaching Hospital, Lahore over a period of 6 months. Total 273 patients satisfying the inclusion criteria were included in this research project. All patients underwent an examination for the calculation of GRACE risk score. After cardiac catheterization, SYNTAX score was calculated. The researcher personally calculated both scores. The parameters was recorded on a pre- designed proforma.

RESULTS: The patients exhibited mean age of 54.81 ± 13.14 years, spanning a range from 30 to 80 years. A higher male-to-female ratio was observe with 164(60.07%) cases being male and 109(39.93%) cases being female. The mean duration of diagnosis was 14.35 ± 5.23 hours with minimum and maximum duration as 6 and 23 hours. The mean Grace risk score was 137.40 ± 13.52 and the syntax score exhibited mean value of 28.68 ± 3. There was correlation of 0.775 among Grace risk score and Syntax score, with significant p-value i.e. < 0.001.

CONCLUSION: A robust positive association exists among GRACE and SYNTAX scores in non-STEMI acute coronary syndrome patients. Hence, grace and syntax score may be applied in our clinical setting for identification of high risk patients (with higher GRACE score) with acute coronary having lower health resources is of much importance to avoid unnecessary work up in low risk patients (low GRACE score) and accurate referral of high risk patients for further workup and management.