A Comparative Study On The Predictive Value Of ACEF,PURSUIT And GRACE Risk Scores In The Prognosis Of Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention

Objective: To investigate which risk stratification tool between the simple ACEF score and the commonly used PURSUIT score and GRACE risk score is more suitable for the prognostic assessment of patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods: One hundred and sixty-eight patients with ACS who underwent PCI in the Department of Cardiovascular Medicine of the Second Clinical School of Inner Mongolia Minzu University from December 2020 to December 2021 were recruited as subjects.They were divided into two groups according to the occurrence of endpoint events: the event group and the none-event group,for which ACEF,PURSUIT and GRACE scores were performed,respectively,and the occurrence of endpoint adverse events during hospitalization and 6 months after discharge were recorded.Moreover,the distribution of the scores of the three scoring tools and that of adverse endpoint events in different scoring modes,the independent risk factors affecting the near-term adverse prognosis,as well as the predictive value of the three different scoring modes for adverse endpoint events during hospitalization and 6 months after discharge in patients with ACS after PCI were analyzed.Results:(1)The incidence of adverse endpoint events in three groups of ACEF score,PURSUIT score and GRACE score increased progressively with increasing scores during hospitalization and within 6 months after discharge.(2)Age(OR=1.079;P=0.007)and peak high-sensitivity troponin T(Pr T)values(OR=1.622;P=0.013),as well as age(OR=1.049;P=0.049)and resting heart rate(OR=1.065;P=0.001)served as factors for poor prognosis during hospitalization and within 6 months of discharge,respectively.(3)The ACEF score,PURSUIT score and GRACE score demonstrated preferable accuracy in predicting adverse endpoint events in patients with ACS after PCI during hospitalization and within 6 months of discharge,and there was no statistically significant difference in the predictive accuracy of the three risk scores.(4)The PURSUIT score had a sensitivity similar to the GRACE score and a specificity similar to the ACEF score for predicting poor prognosis during hospitalization,with a high sensitivity(87.5%)and specificity(57.9%),and its Youden index was the highest among the three(0.454).In addition,the GRACET score had a sensitivity similar to the PURSUI score and a specificity similar to the ACEF score for predicting poor prognosis within 6 months of discharge,with a high sensitivity(72.7%)and specificity(76.7%),and its Youden index was the highest among the three(0.494).Conclusion: Age,peak high-sensitivity troponin T(Pr T)values and resting heart rate are independent risk factors for poor prognosis in patients with ACS after PCI.Of the three scoring tools,the PURSUIT score and GRACE score are applicable to the assessment of the near-term prognosis of patients with ACS after PCI during hospitalization and after discharge,respectively.The ACEF score useful as a supplement to risk stratification.