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August 28, 2015Cardiovascular Journal14 citationsOpen Access

Association of GRACE Risk Score with Angiographic Severity of Coronary Artery Disease in patients with ST Elevation Myocardial Infarction

TSTapash SahaMKMd. KhalequzzamanMAMd Abdul Kader Akanda

Key Result

The GRACE risk score demonstrated a significant positive correlation with the angiographic severity of coronary artery disease, as measured by the Gensini score, in patients with STEMI (r=0.17, p=0.04).

Study Design

Type

Cross-Sectional (n=50)

Multicenter

No

Structured PICO

Does the GRACE risk score correlate with the angiographic severity of coronary artery disease in patients with STEMI?

P
Population
50 patients with ST elevation myocardial infarction admitted within 12 hours of symptom onset who underwent coronary angiography during their index hospitalization.
E
Exposure
GRACE risk score calculation
O
Outcome
Correlation between GRACE risk score and angiographic severity of coronary artery disease (assessed by Gensini score)surrogate

The GRACE risk score positively correlates with angiographic coronary artery disease severity in patients with STEMI, supporting its utility in predicting anatomical disease extent.

Main Result

Effect estimate: r=0.17

p-value: p=0.04

Limitations

  • Small sample size
  • Single centre study
  • Purposive sampling method with risk of selection bias
  • Coronary angiography assessed by visual observation with chance of interobserver variation

Abstract

Background: Clinical guidelines recommend that optimal management of acute coronary syndrome should include patient risk stratification. Predicting the anatomical extension of coronary artery disease is also potentially useful for clinical decision. The objective of our study is to determine whether the GRACE risk score correlates with the angiographic extent and severity of coronary artery disease in patients with ST elevation myocardial infarction.Methodology: 50 patients diagnosed with Acute Myocardial Infarction were included as sample by purposive sampling method. GRACE risk score for each patient was calculated and the patients were divided into groups according to the GRACE risk score: low risk (<108); intermediate risk (109-140). The severity of the coronary artery disease was assessed by vessel score and Gensini score. Relation between Grace score and Gensini score was evaluated.Results: Mean GRACE score of study population was 128.3±22.7. Mean Gensini score was 23.88±17. Mean Gensini score were 15.47±10.4, 27.75±9.26 and 31.52±16.91 in low GRACE risk group, intermediate group and high risk group respectively and the difference of mean Gensini score was statistically significant (p=0.006). In our study correlation co-efficient between GRACE risk score and Gensini score was r=0.17 (p=0.04). Multiple regression analysis showed that age more than 50 years (p=0.02), ST segment deviation (p=0.01), smoking (p=0.02), hypertension (p=0.01) were able to independently predict patients with severe CAD.Conclusion: Our study demonstrates that the GRACE risk score carries a significant positive correlation with the coronary artery disease severity in patients with STEMI.Cardiovasc. j. 2015; 8(1): 30-34

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Cite This Study

Saha et al. (2015) conducted a cross-sectional in ST Elevation Myocardial Infarction (n=50). GRACE risk score vs. Low vs Intermediate vs High GRACE risk score was evaluated on Correlation between GRACE risk score and Gensini score (angiographic severity of coronary artery disease) (r=0.17, p=0.04). The GRACE risk score demonstrated a significant positive correlation with the angiographic severity of coronary artery disease, as measured by the Gensini score, in patients with STEMI (r=0.17, p=0.04).

synapsesocial.com/papers/6a71b930e71d69abee095596https://doi.org/10.3329/cardio.v8i1.24765
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