Key result
In patients with non-ST elevation acute coronary syndrome, a GRACE score of ≥150 was a strong independent predictor of 6-month mortality (adjusted OR 8.43), alongside Killip class II-IV and TIMI score ≥4.
Why the study?
In Southern Asian countries like Pakistan, there was inadequate evidence on risk factors associated with mortality in patients with NSTE-ACS.
Observational (n=280)
No
Answers are grounded in this paper and cite their sources.
In a Pakistani cohort of NSTE-ACS patients, Killip class II-IV, TIMI score >4, and GRACE score ≥150 were strong independent predictors of 6-month mortality, highlighting the utility of these risk scores in this population.
OBJECTIVES: For Southern Asian countries like Pakistan, there is inadequate evidence of risk factors associated with mortality in patients suffering from acute coronary syndrome (ACS), especially non-ST elevation ACS (NSTE-ACS) cases. Therefore, aim of this study was to evaluate predictors of 6-months mortality of patients presenting with NSTE-ACS. METHODS: For this prospective observational study we recruited adult patients diagnosed with NSTE-ACS at a tertiary cardiac center. All he patients were followed-up after six months and survival status was recorded. Logistic regression analysis was performed for six-month mortality and odds ratio (OR) and 95% confidence interval (CI) were reported. RESULTS: Six-month follow-up was successful for 280 patients. On univariate analysis age >65 years, increased heart rate, cardiac arrest at presentation, Killip class II-IV at presentation, and diabetes were found to be associated with increased risk of 6-months mortality with OR [95% CI] of 4.27 [1.9-9.58], 1.25 [1.1-1.41], 139.44 [16.9-1150.78], 68.45 [7.88-594.41], and 2.35 [1.06-5.22] respectively. On multivariable analysis Killip class II-IV at presentation, thrombolysis in myocardial infarction (TIMI) score of >4, and global registry of acute coronary events (GRACE) score ≥150 were found to be independent predictors of mortality after six months of NSTE-ACS with adjusted OR of 32.93 [2.65-408.8], 3.42 [1.35-8.66], and 8.43 [3.33-21.38] respectively. CONCLUSIONS: For patients with NSTE-ACS, our study showed seven clinical parameters to be associated with an increased risk of 6-month mortality. These included increasing age, increased heart rate, cardiac arrest at presentation, Killip class II-IV, diabetes, TIMI score of >4 and GRACE score of >150. Thereby aiding clinicians to apply strategic and precise interventions in monitoring these patients accordingly.
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Kumar et al. (2021) conducted an observational in Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) (n=280). GRACE score ≥150 vs. GRACE score <150 was evaluated on 6-month mortality (OR 8.43, 95% CI 3.33-21.38, p=<0.001). In patients with non-ST elevation acute coronary syndrome, a GRACE score of ≥150 was a strong independent predictor of 6-month mortality (adjusted OR 8.43), alongside Killip class II-IV and TIMI score ≥4.
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