The Relationship Between The GRACE Score And Interventional Treatment Of Non-ST Segment Elevation Acute Coronary Syndrome

Objective: Using the GRACE risk score as a stratification tool to evaluate thetreatments and prognosis of non-ST segment elevation acute coronary syndromepatients in Fujian Provincial Hospital, in order to improving the current treatments,reducing unnecessary invasive procedures and the burdens of patients.Methods: Retrospective collected and analyzed risk factors, clinical manifestations,laboratory datas, imaging findings, treatments and prognosis of non-ST-segmentelevation acute coronary syndrome inpatients in Fujian Provincial Hospital from1January2013to31December2013. The patients were divided into three groupsaccording the GRACE risk score (GRACE <108was divided into low-risk,109to140divided into medium risk, and>140divided into high-risk), compared theirGRACE score and indicators.Results：①Male were more than female patients in both high-risk and low-riskgroup. The group which has the largest number in low-risk patients was the60-69agegroup, and in high-risk patients was the70-79age group, the number of patientsincrease with increasing age to some extent. But the difference of male and female’sGRACE score had no statistically significant.②The GRACE score was higher in theNSTEMI patients than the UAP patients.③The average number of Hospitalizationdays of the NSTEMI patients was longer. The NSTEMI patients had morecardiovascular events during the hospitalization.④With prolonged hypertensionprevalence, GRACE score increased. The presence or absence of diabetes and thelevels of glycosylated hemoglobin had no correlation with the GRACE score.⑤Withthe elevated of NT-proBNP, the GRACE score also increased.⑥Single or multivessel disease had no significant discrepancy in GRACE score. Anterior descendingartery, circumflex artery and right coronary lesions’ GRACE score had no significantdiscrepancy, but in patients with left main disease, the GRACE score was higher thanthose without.⑦There was no significant discrepancy between high-risk andlow-risk patients in the rate of coronary angiography. There was too little patientsundergoing PCI or PTCA in those who had coronary angiography, especially inlow-risk patients.Conclusion： NT-proBNP and the GRACE risk score levels were positivecorrelated.It can assist clinicians in determine disease severity of NSTE-ACS patientsquickly. TG, CHO and GRACE score were negatively correlated. Pre-hypertensionand blood sugar levels have no correlation with the GRACE risk score.In the year of2013, there was too much unnecessary angiography for the patientsof Fujian Provincial Hospital. Calculating the GRACE risk score and combined other indicators such as NT-proBNP can reduce unnecessary angiography and the burden onpatients, and let doctors can choose more targeted treatment strategies for patients.