Key result
The GRACE score predicted 30-month all-cause mortality with an AUC of 0.71, which was not significantly different from the Gensini score's AUC of 0.66 (p=0.417).
Why the study?
Patients with NSTE-ACS require early risk stratification to improve prognosis and guide reperfusion decisions, motivating an evaluation of the correlation and prognostic value of GRACE versus Gensini scores.
Do the GRACE and Gensini scores predict long-term all-cause mortality in patients with NSTE-ACS?
Observational (n=220)
No
Do the GRACE and Gensini scores predict long-term all-cause mortality in patients with NSTE-ACS?
Effect estimate: AUC 0.71 (95% CI 0.60-0.82)
Absolute Event Rate: 0.71% vs 0.66%
p-value: p=0.417
Both the GRACE and Gensini scores are valid predictors of long-term all-cause mortality in patients with NSTE-ACS, with the GRACE score showing a slightly higher but statistically comparable predictive value.
GRACE and Gensini scores show comparable mortality prediction in NSTE-ACS; leaves open whether either refines routine risk stratification pending prospective validation.
Introduction: Patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) should undergo risk stratification as soon as possible after their presentation. Early risk satisfaction provides good prognosis for patients as well as better decision for reperfusion therapy. The aim of this study is to find a correlation between the Global Registry of Acute Coronary Events (GRACE) risk score and severity of coronay artery disease assessed by Gensini score score and compare the value of GRACE and Gensini scores in predicting the long-term outcomes in patients with NSTE-ACS. Methods: A total of 220 patients with NSTE-ACS who underwent coronary angiography were enrolled in our study. The Gensini score was used to assess the severity of coronary artery disease. According to the GRACE score, the patients were grouped into low, intermediate and high groups. After 30 months of follow-up, 20 patients died. Results: The mean Gensini scores were 11.8 ± 11.5, 27.4 ± 30.9, and 42.9 ± 29.7 in the low, intermediate and high-risk groups, respectively. The GRACE scores and Gensini score had a moderate positive correlation (rho = 0.522, p < 0.001). The survival rates showed a less rapid deterioration from the low to high GRACE groups (P = 0.013) than when classified according to their Gensini tertiles (P = 0.02). Area under the ROC curve was statistically significant for both scores, but area of the GRACE risk score (0.71; 95% Cl = 0.60 - 0.82) was higher than that the Gensini risk score (0.66; 95% Cl = 0.53 – 0.80). Conclusion: Our study revealed that the Gensini score had a positive and significant relationship with the GRACE score in patients with NSTE-ACS. The GRACE score had a more value in predicting long-term outcomes in patients with NSTE-ACS.
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Hoang et al. (2021) conducted an observational in Non-ST-elevation acute coronary syndrome (n=220). GRACE score vs. Gensini score was evaluated on Prediction of all-cause mortality (Area under the ROC curve) (AUC 0.71, 95% CI 0.60-0.82, p=0.417). The GRACE score predicted 30-month all-cause mortality with an AUC of 0.71, which was not significantly different from the Gensini score's AUC of 0.66 (p=0.417).
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