The Clinical Study Combined GRACE Risk Score And Cystatin C To Evaluate Coronary Stenosis And Predict Cardiovascular Events In Patients With ACS

ObjectiveTo analyze the quantitative relationship between different degree of coronary artery lesionsand GRACE risk score and cystatin C level in patients with acute coronary syndrome (ACS),and to evaluate its predictive value for cardiovascular events.Methods197hospitalized ACS patients with complete clinic information from January2006toJanuary2012were enrolled. The patients with ACS were divided into UAP, NSTEMI, STEMIgroups. According to the relevant clinical variables of all patients to hospital GRACE riskstratification. The GRACE score divided into three groups: low-risk group (<96points),median risk group (96to133points) and the high-risk group (>133points). We collected their，sgeneral clinical data, medical history, biochemical indicators (urinary chalone C, serumglucose, lipid, serum creatinine, myocardial necrosis markers and liver function,electrocardiogram, etc), medication compliance, coronary angiography, and the occurrence ofmajor cardiovascular events in patients with follow-up of all. According to coronaryangiography (coronaryangiography, the CAG), Gensini score was utilized to definite thedisease severity, The Gensini score divided into three groups：<60for the low-risk group,60-87for the medium risk group for the,87for the high-risk group. Finally we evaluatewhether GRACE risk score, cystatin C levels are associated with different severity ofcoronary，and whether they have the predictive value for predic cardiovascular events. Results1. GRACE risk score, cystatin C levels and Gensini score were positive correlated. Thecorrelation coefficient was0.318and0.173. Cystatin C levels GRACE risk score werepositive correlated, the correlation coefficient was0.457. Cystatin C levels in differentGRACE risk score groups were significantly different.2. The GRACE risk score and Gensini scores were significantly different among the threegroups of ACS.3. The cystatin C levels betwwen the three groups of GRACE risk score were significantlydifferent.4. The occurrence of cardiovascular events between the three groups of Gensini score aredifferent.5. Combination of GRACE risk score and cystatin C levels can not predict the occurrence ofthe cardiovascular events of30days.6. The GRACE score had an area under the ROC curve of0.623at predicting the occurrence ofthe cardiovascular events in one year. The cystatin C levels had an area under the ROCcurve of0.706at predicting the occurrence of the cardiovascular events in one year. UnitedGRACE risk score and cystatin C levels had an area under the ROC curve of0.721atpredicting the occurrence of the cardiovascular events in one year.ConclusionThe Cystatin C levels and GRACE risk score were positive correlated. GRACE risk score,cystatin C levels and coronary stenosis were positive correlated. The Combination of theGRACE risk score and cystatin C levels provide us important information for prediction ofthe occurrence of cardiovascular events on patients with ACS.