Utilization of Positive Predictive Value of GRACE score in predicting obstructive coronary artery disease in NSTEMI patients taking coronary angiography as gold standard
DOI:
https://doi.org/10.55958/jcvd.v20i2.197Keywords:
Acute Myocardial Infarction, NSTEMI, GRACE score, Angiography, Coronary Artery DiseaseAbstract
INTRODUCTION: The Global Registry of Acute Coronary Events (GRACE) risk score is widely utilized to predict major adverse cardiovascular events (MACE) in patients with non-ST-elevation myocardial infarction (NSTEMI). However, its effectiveness in prognostic stratification remains uncertain. This study aims to evaluate the positive predictive value of the GRACE score in identifying obstructive coronary artery disease (CAD) among NSTEMI patients in the local population. Early diagnosis and treatment of obstructive CAD using this approach may contribute to reducing the morbidity and mortality associated with the condition.
OBJECTIVE: To determine the Positive Predictive Value (PPV) of GRACE score in predicting obstructive CAD in NSTEMI patients taking coronary angiography as gold standard.
MATERIAL & METHODS: This Cross-sectional study was conducted at Cardiology Department, Mayo Hospital, Lahore from August 1, 2023 to January 31, 2024. Total 135 patients fulfilling the selection criteria were enrolled. Patients with NSTEMI having suspected obstructive CAD on GRACE score underwent coronary angiography and true positive and true negative were labeled upon it.
RESULTS: In this study, 135 patients with NSTEMI were enrolled. Among these patients, 81(60.0%) were males, while 54(40.0%) were females. Age range in this study was from 30 to 70 years with mean age of 49.19±13.221 years. Mean BMI of patients was 27.6±5.74 kg/m2. Mean duration of NSTEMI was 8.4±2.5 hours. Mean GRACE score was 95.89±21.15. According to case outcome, 85(63.0%) were true positive and 50(37.0%) were false positive.
CONCLUSION: The GRACE score demonstrates moderate predictive value in identifying obstructive coronary artery disease (CAD) in patients with NSTEMI. While it can serve as a useful screening tool, its effectiveness in assessing the extent of CAD remains limited.
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