Abstract 12566: Relationship Between GRACE Risk Score and Serial Changes of Angiographic Findings in Patients with Acute Coronary Syndromes
Background: Global Registry of Acute Coronary Events (GRACE) risk score is an established tool for assessing risk in patients with acute coronary syndrome (ACS). However, the relation between GRACE risk score and serial changes of angiographic findings in patients with ACS is unclear.
Methods: We studied 262 patients (218 men, mean age 64 + 10 years) with ACS undergoing percutaneous coronary intervention (PCI) for culprit lesion during initial hospitalization. All patients underwent serial coronary angiograms (CAGs) immediately before PCI, and at 6 + 3 months and 60 + 10 months after presentation. For each patient, GRACE risk score was calculated at acute presentation. Discriminatory performance was measured by the c-statistics (area under receiver-operating characteristic curve). Morphological change was defined as change in the morphology of lesion in nonculprit artery from simple to complex between 2 serial CAGs. Coronary disease progression (CP) was defined as an increase >15% in stenosis severity of lesion in nonculprit artery between 2 serial CAGs.
Results: The c-statistics of the GRACE risk score for initial and follow-up angiographic findings were shown in Table. Multivariate analysis revealed that the independent predictors of CP between second and final CAGs were GRACE risk score >140 (odds raio 3.39, 95% CI 1.87 to 6.14, p<0.001), diabetes mellitus (odds raio 1.81, 95% CI 1.01 to 3.27, p=0.048), and non-ST-segment elevation ACS (odds raio 3.21, 95% CI 1.75 to 5.90, p<0.001).
Conclusion: GRACE risk score provides significant diagnostic information with regard to severity and instability all around the coronary artery tree among patients with ACS undergoing PCI. These findings may partly explain the reasons for the excellent discrimination of GRACE risk score for adverse outcomes across the broad spectrum of the patients with ACS.
- © 2012 by American Heart Association, Inc.