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Relation of the aortic stiffness with the GRACE risk score in patients with the non ST-segment elevation myocardial
Gedikli Omer1, Aksan Gokhan2, Uzun Adem1
1Departmant of Cardiology, Artvin State Hospital Artvin, Turkey.
Insights
Aortic stiffness is linked to higher Global Registry of Acute Coronary Events (GRACE) risk scores in Non-ST-elevation myocardial infarction (NSTEMI) patients. Measuring aortic stiffness may improve risk assessment for acute coronary syndrome (ACS).
Area of Science:
- Cardiology
- Vascular Physiology
- Medical Diagnostics
Background:
- Clinical risk scores guide treatment for Non-ST-elevation myocardial infarction (NSTEMI).
- Aortic elasticity and stiffness are associated with Coronary Artery Disease (CAD) severity.
- The relationship between aortic stiffness and clinical risk scores in NSTEMI is not well-established.
Purpose of the Study:
- To investigate the association between aortic stiffness and the Global Registry of Acute Coronary Events (GRACE) risk score in NSTEMI patients.
- To determine if aortic stiffness can serve as an independent predictor of high GRACE risk scores.
Main Methods:
- Prospective analysis of 87 NSTEMI patients.
- Calculation of aortic elastic and stiffness parameters using echocardiography and sphygmomanometry.
- Categorization into low (GRACE ≤ 140) and high (GRACE > 140) risk groups.
Main Results:
- High-risk patients exhibited significantly lower aortic strain and higher aortic stiffness index compared to low-risk patients (p < 0.001).
- Aortic stiffness index was the sole independent predictor of GRACE risk score in multivariate analysis (OR: 119.390; p = 0.011).
Conclusions:
- A significant correlation exists between aortic stiffness, impaired elasticity, and GRACE risk score in NSTEMI.
- Aortic stiffness index independently predicts high GRACE risk scores.
- Incorporating aortic stiffness into risk scores may enhance risk classification for Acute Coronary Syndrome (ACS) patients.
Background:
Current guidelines recommend clinical risk scoring systems for the patients diagnosed and determinated treatment strategy with in Non-ST-elevation elevation myocardial infarction (NSTEMI). Previous studies demonstrated association between aortic elasticity properties, stiffness and severity CAD. However, the associations between Aortic stiffness, elasticity properties and clinical risk scores have not been investigated. In the present study we have evaluated the relation between the Global Registry of Acute Coronary Events (GRACE) risk score and aortic stiffness in patients with NSTEMI.
Method:
We prospectively analyzed 87 consecutive patients with NSTEMI. Aortic elastic parameter and stiffness parameter were calculated from the echocardiographically derived thoracic aortic diameters (mm/m(2)), and the measurement of pulse pressure obtained by cuff sphygmomanometry. We have categorized the patients in to two groups as low ((n = 45) (GRACE risk score ≤ 140)) and high ((n = 42) (GRACE risk score > 140)) risk group according to GRACE risk score and compare the both groups.
Results:
Table 1 shows baseline characteristics of patients. Our study showed that Aortic strain was significantly low (3.5 ± 1.4, 7.9 ± 2.3 respectively, p < 0.001) and aortic stiffness index was significantly high (3.9 ± 0.38; 3 ± 0.35, respectively, p < 0.001) in the high risk group values compared to those with low risk group. The aortic stiffness index was the only independent predictor of GRACE risk score (OR: 119.390; 95% CI: 2.925-4872.8; p = 0.011) in multivariate analysis.
Conclusion:
We found a significant correlation between aortic stiffness, impaired elasticity and GRACE risk score. Aortic stiffness index was the only independent variable of the high GRACE risk score. The inclusion of aortic stiffness into the GRACE risk score could allow improved risk classification of patients with ACS at admission and this may be important in the diagnosis, follow up and treatment of the patients.
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