Study On The Relationship Between GRACE Risk Score, EGFR And The Severity Of Coronary Artery Disease

Background and purpose:The number of patients who are suffering coronary heart disease which is considered as one of the most jeopardizing diseases to mankind has increased. It is the No.1killer around the world every year. Acute coronary syndrome (ACS) is the typical clinical type of acute onset triggered by acute myocardial ischemia, including unstable angina (UA), non-ST elevated myocardial infarction (NSTEMI), and ST elevated myocardial infarction (STEMI).The former two are described as NSTE-ACS, which is featuring urgent onset, severe state, quick change, varied prognosis and high death rate. The sereveness of lesion in coronary artery is of crucial significance in its developmental progress. Coronary angiogram, which is deemed as the golden criteria, can help us to understand coronary artery stenosis and coronary blood flow. For a patient who is suffering acute coronary syndrome, should we primarily presume the sereveness of lesion and the number of lesion vessels according to the clinic data and examination factors before conducting coronary angiogram? This paper aims to analyze the relation between the different category of eGFR and GRACE and the severeness of lesion and the number of lesion vessels of the patient and the assumption significance of how the two impact the lesion of vessels of coronary artery.Method:Select206cases of ACS patients who has consistent inpatient records from January2014to September2014. Collect the information including gender, age, height, weight, past medical history, family history, smoking history, sudden cardiac arrest, heart rate, systolic pressure, killip scores, ST sectional deviation, serum creatinine, assessment of the makers in myocardial enzyme, blood fat, hematuresis routine and hepatorenal function. Calculate the GRACE risk stratification scores and eGFR. Categorize into single-vessel, double-vessel and multiple-vessel lesions according to the outcome of coronaryangiography(CAG), and define the rates of severeness of the lesion with GENSINI scores, analyze the relation between GRACE risk stratification scores and eGFR and the severeness of lesion and the number of lesion vessels, and the significance of clinic assumption.Result:1. It shows that as the lesion severeness increases in Gensini scores of the ACS patients, the risk stratification of GRACE will rise (P=0.019). It is statistically significant in such difference, and that of eGFR reduction (P=0.032) is also statistically significant.2. It shows that as the number of lesion vessels increases in GRACE scores of the ACS patients, the risk stratification of GRACE will rise (P=0.041). It is statistically significant in such difference, and that of eGFR reduction (P=0.045) is also statistically significant.3. GRACE scores is divided into highly-risk group, middle-risk group and low-risk group. Gensini scores and the number of lesion vessels are statistically significant in their difference, and the relativity of the two is (r=0.138, r=0.387)4. eGFR scores is divided into normal group, slight-injured group, and moderately-and-severely-injured group. Gensini scores and the number of lesion vessels are statistically significant in their difference, and the relativity of the two is (r=-0.303, r=-0.263)Conclusion:The GRACE scores of the ACS patients is positively correlated with the lesion severeness and the number of lesion vessels; the eGFR scores is negatively correlated with the lesion severeness and the number of lesion vessels.