ABSTRACT

The Global Registry of Acute Coronary Events (GRACE) risk score; a commonly used risk scoring system; predicts hospital and 6-month survival rates of patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate whether the GRACE risk score could also predict the extent of diseased coronary vessels in patients with non-ST elevation acute coronary syndrome.

We evaluated 95 patient data retrospectively who were hospitalized with a diagnosis of non-ST elevation ACS between 2005-2006 at the Istanbul University Cardiology Institute. All the patients’ GRACE risk scores were calculated and coronary angiograms were re-analysed. We further divided the patients into three groups according to risk score (Low risk score: <108, medium risk score: 109-140, high risk score: >141) and evaluated the association between the GRACE risk score and the number of diseased coronary arteries.

After GRACE risk score calculation; the number of low risk, medium risk and high risk patients were 38 (%40), 44 (%46.4) and 13 (%13.6) respectively. Three-vessel disease was insignificantly higher in low and medium risk groups but statistically significant in high risk group. (p<0.01). Patients with low ejection fraction (<40%) were more numerous in the high risk group than medium and low risk groups (p<0.05). number of patients with estimated glomerular filtration rate (eGFR) less than 60 mL/ dk/1.73 m² was higher in medium and high risk groups than the low risk group (p<0.001).

As the GRACE risk score calculated in emergency room for ACS patients can predict in-hospital mortality and clinical events, it may also predict coronary anatomy, low ejection fraction and low eGFR.

Keywords: GRACE risk score, non-ST elevation acute coronary syndrome, coronary anatomy