Correlation between GRACE Risk Score and Coronary Angiographic Complexity in High Risk NSTEMI Patients
DOI:
https://doi.org/10.55958/jcvd.v20i2.184Keywords:
GRACE risk score, coronary angiography, SYNTAX score, NSTEMI, risk stratificationAbstract
Abstract Background:Despite advances in cardiovascular care, administration of the non-ST-elevation acute coronary syndrome (ACS) spectrum including non-STEMI has come to represent a significant challenge, necessitating appropriate risk stratification techniques that could predict patient risk and tailor therapy.
Objective:To assess the association between the GRACE risk score and coronary angiographic complexity in patients with Non-ST-Elevation Myocardial Infarction (NSTEMI).
Methodology:From January 2022 to January 2023, a prospective cross-sectional study was conducted at the Department of Cardiology, Hayatabad Medical Complex, Peshawar. GRACE and SYNTAX scores were calculated for each of the 250 NSTEMI patients. Analyzing the association between SYNTAX scores and GRACE using Pearson correlation. and logistic regression was employed to evaluate the predictive capacity of the GRACE score for obstructive coronary artery disease.
Results:The mean GRACE score was 132.3 ± 34.7, while the mean SYNTAX score was 22.5 ± 12.8. The findings indicated a moderate positive association between the GRACE and SYNTAX scores (r = 0.45, p < 0.001). The GRACE score independently predicted the occurrence of obstructive coronary artery disease, as evidenced by logistic regression analysis (OR = 1.05, p < 0.01).
Conclusion:The study have recommended the GRACE score for identifying a higher number of NSTEMI patients at risk of increased mortality; and also as an additional index to infer the severity of coronary angiographic complexity in NSTEMI patients. Usage of this score, in clinical setting may lead to tailored treatment strategies.
References
References
Rahmani R, Majidi B, Ariannejad H, Shafiee A. The Value of the GRACE Score for Predicting the SYNTAX Score in Patients with Unstable Angina/Non-ST Elevation Myocardial Infarction. Cardiovasc Revascularization Med [Internet]. 2020 Apr;21(4):514–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S155383891930435X
Wang XF, Zhao M, Liu F, Sun GR. Value of GRACE and SYNTAX scores for predicting the prognosis of patients with non-ST elevation acute coronary syndrome. World J Clin Cases [Internet]. 2021 Nov 26;9(33):10143–50. Available from: https://www.wjgnet.com/2307-8960/full/v9/i33/10143.htm
D’Ascenzo F, Biondi-Zoccai G, Moretti C, Bollati M, Omedè P, Sciuto F, et al. TIMI, GRACE and alternative risk scores in Acute Coronary Syndromes: A meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients. Contemp Clin Trials [Internet]. 2012 May;33(3):507–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1551714412000195
Abadeer MA, Sallam WM, Onsy AM. Coronary Artery Calcium Scoring by Computed Tomography and the GRACE Risk Score as Predictors of Obstructive Coronary Artery Disease in Patients with Non-ST Segment Elevation Acute Coronary Syndrome: A Comparative Study. QJM An Int J Med. 2023 Aug;116(Supplement_1).
Everett CC, Fox KA, Reynolds C, Fernandez C, Sharples L, Stocken DD, et al. Evaluation of the impact of the GRACE risk score on the management and outcome of patients hospitalised with non-ST elevation acute coronary syndrome in the UK: protocol of the UKGRIS cluster-randomised registry-based trial. BMJ Open. 2019 Sep;9(9):e032165.
Cid Alvarez AB, Gomez-Peña F, Redondo-Dieguez A, Avila A, López D, Sanmartin X, et al. Prognostic impact of the SYNTAX score II in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: analysis of a four-year all-comers registry. EuroIntervention. 2019 Oct;15(9):e796–803.
Hassan M, Kubra G, Sabeen M, Nadeem D, Murtaza A, Sikandari F. Correlation of TIMI Risk Score and GRACE Risk Score with Lesion of Coronary Artery Disease in Patients with Non-ST Segment Elevation Acute Coronary Syndrome. Pakistan J Med Heal Sci. 2023 Jul;17(6):205–7.
Yalcin Ocak N, Yesilaras M, Kilicaslan B, Eyler Y, Mutlu ?, Kutlu M. Comparing TIMI, HEART, and GRACE Risk Scores to Predict Angiographic Severity of Coronary Artery Disease and 30-Day Major Adverse Cardiac Events in Emergency Department Patients with NSTEACS. Prehosp Disaster Med [Internet]. 2023 Dec 13;38(6):740–8. Available from: https://www.cambridge.org/core/product/identifier/S1049023X23006490/type/journal_article
Namazi MH, Mazloomi SS, Aghamohammadi MK. Correlation Between TIMI Risk Score and the Number of Vessels Involved in the Angiographic Study; a Cross-sectional Study. Arch Acad Emerg Med. 2022;10.
Dakhil ZA, Farhan HASAN. Coronary angiographic profile in non ST elevation acute coronary syndrome: risk stratification and management strategy. Eur J Prev Cardiol. 2023 May;30(Supplement_1).
Elhusseini S. Credibility of Risk scores in predicting coronary artery disease severity in non-ST segment elevation acute coronary syndrome patients. Eur Heart J [Internet]. 2020 Nov 1;41(Supplement_2). Available from: https://academic.oup.com/eurheartj/article/doi/10.1093/ehjci/ehaa946.1374/6004515
Demandt JPA, Zelis JM, Koks A, Smits GHJM, van der Harst P, Tonino PAL, et al. Prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome: a systematic review and meta-analysis. BMJ Open. 2022 Apr;12(4):e057305.
Gale CP, Stocken DD, Aktaa S, Reynolds C, Gilberts R, Brieger D, et al. Effectiveness of GRACE risk score in patients admitted to hospital with non-ST elevation acute coronary syndrome (UKGRIS): parallel group cluster randomised controlled trial. BMJ. 2023 Jun;e073843.
Yin G, Abdu FA, Liu L, Xu S, Xu B, Luo Y, et al. Prognostic Value of GRACE Risk Scores in Patients With Non-ST-Elevation Myocardial Infarction With Non-obstructive Coronary Arteries. Front Cardiovasc Med. 2021 Feb;8.
Khawaja AZ, Shahzad SK, Khalil M, Aziz Z, Ahmed M, Kiani SS, et al. Comparison of GRACE Score and SYNTAX Score in Predicting Complexity of Coronary Artery Disease in Patients with NST-ACS. Pakistan Armed Forces Med J. 2023;
Maltes S, Paiva MS, Madeira S, Teles RC, Almeida MS, Mendes M. Correlation between NSTE-ACS risk scores with Syntax: can we predict coronary lesion complexity before angiography? Eur Heart J. 2022 Oct;43(Supplement_2).
Ishaq H, Akhtar BM, Kumar M, Shar GS, Hakeem AR, Masood S, et al. THE PREDICTIVE UTILITY OF GRACE SCORE FOR OBSTRUCTIVE CORONARY ARTERY DISEASE IN PATIENTS WITH NON ST ELEVATION MYOCARDIAL INFARCTION. Pakistan Hear J. 2021;
Sofidis G, Otountzidis N, Stalikas N, Karagiannidis E, Papazoglou AS, Moysidis D V., et al. Association of GRACE Risk Score with Coronary Artery Disease Complexity in Patients with Acute Coronary Syndrome. J Clin Med [Internet]. 2021 May 20;10(10):2210. Available from: https://www.mdpi.com/2077-0383/10/10/2210
Cedro AV, Mota DM, Ohe LN, Timerman A, Costa JR, Castro L de S. Association between clinical risk score (Heart, grace and TIMI) and angiographic complexity in acute coronary syndrome without st segment elevation. Arq Bras Cardiol [Internet]. 2021 Aug 9;117(2):281–7. Available from: https://abccardiol.org/article/associacao-entre-escores-de-risco-clinico-heart-grace-e-timi-e-complexidade-angiografica-na-sindrome-coronaria-aguda-sem-elevacao-do-segmento-st/
Zaridi I, Qadi CA El, Essaket I, Rachid L, Jamili M El, Hattaoui M El. The Correlation between Clinical Risk Score (Heart, Grace and TIMI) and Angiographic Coronary Artery Complexity in NSTEMI. SAS J Med. 2022;