The Predictive Value for Long-term Prognosis of GRACE Score and SYNTAX Score in Patients With Non-ST Elevation Acute Coronary Syndrome
10.3969/j.issn.1000-3614.2015.08.003
- VernacularTitle:GRACE评分和SYNTAX评分对非ST段抬高急性冠状动脉综合征患者的远期预后评估
- Author:
Shaohui ZHANG
;
Lixin LIU
;
Guanghe WEI
;
Tiecheng WANG
;
Jianjun WANG
;
Yi AN
;
Guoliang YANG
;
Anyong CHEN
;
Ying GUO
;
Yuedong LIN
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Non-ST elevation acute coronary syndrome;
GRACE score;
SYNTAX score;
Prognostic evaluation
- From:
Chinese Circulation Journal
2015;(8):728-732
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods.
Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P<0.01). Survival analysis presented that by GRACE score system, the MACE occurrence rates in Low risk group, Medium risk group and High-risk group were elevated accordingly as 13.81%, 23.64% and 36.55% respectively. And by SYNTAX system, MACE occurrence rates in Medium risk group and High-risk group were 39.29% and 37.93%, which were both higher than that in Low risk group (23.99%), while the scores between Medium and High risk groups were similar,P>0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences.
Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.
