Incorporating non-gated chest CT coronary artery calcium scores significantly improved GRACE score AUC from 0.702 to 0.798 for predicting MACE after PCI in ACS patients.
Does adding non-gated chest CT coronary artery calcium score to the GRACE score improve the prediction of major adverse cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention?
Adding non-gated chest CT coronary artery calcium scores to the GRACE score significantly improves risk stratification for MACE in ACS patients post-PCI.
Absolute Event Rate: 0% vs 0%
ABSTRACT Objective To evaluate the incremental value of non‐gated chest CT coronary artery calcium score in enhancing GRACE score prediction of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods A retrospective cohort study was conducted on 324 ACS patients undergoing PCI and non‐gated chest CT. Patients were divided into MACE ( n = 100) and non‐MACE ( n = 224) groups with a median follow‐up of 18.7 months. The predictive performance of the GRACE score, Agatston score, and combined clinical composite model was evaluated using receiver operating characteristic (ROC) curves and survival analysis based on optimal cutoff values. Results Model 3 (GRACE + CACS) demonstrated AUC values of 0.798 and 0.827 in the training and testing cohorts, respectively, significantly outperforming Model 1 (GRACE) (training AUC = 0.702; testing AUC = 0.758). Model 4, incorporating clinical features, demonstrated optimal predictive performance (training set AUC = 0.806; testing set AUC = 0.857). The AUC differences were statistically significant ( p < 0.05). Survival curves revealed the highest MACE incidence (94.4%, p < 0.01) in the high‐risk combined Ga1 group (GRACE ≥ 140 and Agatston ≥ 400). Conclusion The non‐gated chest CT coronary calcification score significantly enhances the predictive value of the GRACE score for major adverse coronary events (MACE) after coronary intervention. When combined with clinical indicators, the predictive power is further improved. Sensitivity analysis confirms the robustness of this finding, providing a reliable tool for clinical risk stratification.
Xing et al. (Mon,) reported a other. Incorporating non-gated chest CT coronary artery calcium scores significantly improved GRACE score AUC from 0.702 to 0.798 for predicting MACE after PCI in ACS patients.