Clinical Study On The Relationship Between Grace Risk Score And The Severity Of Coronary Artery Pathological Changes In Patient With Acute Coronary Syndrome

Background:Acute coronary syndrome (ACS) is a clinical syndrome which caused by the instability and vulnerability of plaque, and in which there are three clinical types:unstable angina pectoris (UAP), non-ST segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). An important treatment-risk paradox exists in the management of ACS. An appropriate treatment strategy for ACS should include an estimate of patient's baseline risks, which can be achieved by application of a risk model that integrates important prognostic features. A number of such models had been developed. Global Registry of Acute Coronary Events (GRACE) risk stratification is the most important risk model, it was confirmed to can predict the prognosis and guide medical therapy both in STEMI and NSTE ACS. But, whether the GRACE risk score can or not predict the extent and severity of coronary artery pathological change is unknown.Purposes:The present study has been designed to determine whether the GRACE risk score (RSs) correlates with the angiographic extent and severity of coronary artery disease (CAD) in patients with ACS undergoing cardiac catheterization.Methods and Results:We conducted a retrospective review of 161 consecutive medical records of patients who underwent coronary angiography secondary to ACS from Oct 2008 to Oct 2009 [age:61.42±10.64 years,73.29% male, 41.61% with STEMI,19.25% with UAP,39.13% with NSTEMI]. For each patient, GRACE RSs were calculated by using specific variables collected at admission. Patients were classified into 3 categories (low, middle and high risk) according to GRACE RSs. The results of coronary angiography in every patient were also reviewed. The relationships between GRACE RSs and extent or severity of coronary artery stenosis were analyzed (The correlation coefficients were 0.463 and 0.499, respectively). One-vessel lesion and mild stenosis of coronary artery were more often found in patients with low risk group by GRACE RSs, and three-vessel or left-main lesions and heavy stenosis of coronary artery were more often found in patients with high risk group by GRACE RSs.Conclusions:There are good relationships between the GRACE risk scores and the angiographic severity and extent of CAD in patients with ACS who are referred for cardiac catheterization. GRACE risk score category for the noninvasive assessment of the coronary stenotic severity has the important prognostic value.