Prognostic Value Of The SYNTAX And GRACE Score In Patients With Acute Myocardial Infarction Three-vessel Disease

Background：Coronary heart disease is a common disease often seen in thecardiology department. Using risk scoring system to quantify the risk and to evaluatethe prognosis of patients enables doctors and patients together to select reasonableand appropriate treatment, and to strengthen the future management of patients inorder to further reduce the incidence of adverse cardiovascular and cerebrovascularevents.Objectives：This study intends to combine anatomy-related SYNTAX (Synergybetween Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) scoreand GRACE (Global Registry of Acute Coronary Events) score which includes onlyclinical variables into a new clinical risk score named NewScore, and to explore itsprognostic value of the SYNTAX and GRACE score in patients with acutemyocardial infarction three-vessel disease.Methods：In this retrospective study, we collected clinical data of patientsadmitted from February2011to January2012with acute myocardial infarction andthree-vessel disease confirmed by coronary angiography. We calculated theSYNTAX score and GRACE score, followed patients for2years of time after theonset of the disease. COX regression model was used to form a new clinical riskscore; SYNTAX score, GRACE score and NewScore were compared by ROC(Receiver Operating Characteristic) curve analysis, survival analysis and otherstatistical methods. Results：In STEMI (ST-segment Elevation Myocardial Infarction) subgroupduring1year follow-up, the expression of NewScore is2.3*SYNTAX score+GRACE score; low-risk group:27-151, median risk group:152-202, high-riskgroups:203and above; the area under the ROC curve of SYNTAX score, GRACEscore and NewScore are0.648,0.644and0.699, respectively; there is no significantdifference in the area under the curve. The incidence of adverse events in thelow-risk group of NewScore is the lowest among the three scoring system (10.4%),and the incidence of adverse events in the high-risk group is the highest of all(58.8%).Conclusion：The prognostic value of NewScore, SYNTAX score and GRACEscore are considerably the same in the ST-segment elevation myocardial infarctionpopulation during1year follow-up. NewScore can better distinguish betweenlow-risk and high-risk patients.