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Relation between the GRACE score and severity of atherosclerosis in acute coronary syndrome

Mehmet Akif Cakar1, Salih Sahinkus1, Ercan Aydin1

  • 1Cardiology Department, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey.

Journal of Cardiology
|September 10, 2013
PubMed

Insights

The Global Registry of Acute Coronary Events (GRACE) score effectively predicts coronary artery disease severity in non-ST-elevation acute coronary syndrome patients. Higher GRACE scores correlate with more severe and extensive coronary artery stenosis.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Risk Stratification

Background:

  • Non-ST-elevation acute coronary syndrome (NSTE-ACS) patient populations exhibit significant heterogeneity.
  • Risk stratification is crucial for managing NSTE-ACS, guiding treatment decisions and predicting outcomes.
  • The Global Registry of Acute Coronary Events (GRACE) score is a widely used tool for assessing risk in ACS patients.

Purpose of the Study:

  • To investigate the correlation between the GRACE score and the severity of coronary artery disease (CAD) in NSTE-ACS patients.
  • To evaluate the angiographic severity of CAD using the Gensini score in relation to GRACE risk stratification.
  • To determine if the GRACE score can predict the extent of coronary artery stenosis in NSTE-ACS.

Main Methods:

  • A cohort of 245 NSTE-ACS patients was analyzed.
  • Patients were stratified into low, intermediate, and high-risk groups based on the GRACE score.
  • Coronary angiography was performed within five days of admission to assess coronary artery disease severity via the Gensini score.

Main Results:

  • A significant positive correlation was observed between GRACE risk groups and Gensini scores (p=0.016).
  • The high-risk GRACE group demonstrated significantly higher Gensini scores compared to the low-risk group (p=0.013).
  • The prevalence of multivessel disease increased with higher GRACE risk categories, with 42% in the high-risk group versus 28% in the low-risk group (p<0.01).

Conclusions:

  • The GRACE score is a valuable tool for assessing the severity of coronary artery stenosis in NSTE-ACS patients.
  • GRACE score effectively predicts the extent and severity of coronary artery disease, aiding in risk stratification.
  • These findings support the use of the GRACE score in clinical practice for managing NSTE-ACS patients.
Abstract

Keywords:
Acute coronary syndromeGRACE scoreGensini score

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