Clinical Study On The Relationships Between GRACE Risk Score Or Concentration Of Plasma D-Dimer And The Severity Of Coronary Artery Pathological Changes In Patients With Acute ST-segment Elevation Myocardial Infraction

Objective:The present study has been designed to determine whether the GRACE risk score or concentration of plasma D-dimer correlate with the angiographic extent and severity of coronary artery disease in patients with acute ST-segment elevation myocardial infraction,and to evaluate how GRACE risk score and plasma D-dimer predict the severity of coronary artery pathological changes.Methods:We conducted a retrospective review of84consecutive medical records of patients with STEMI in Yangzhou NO.1People’s Hospital from Jun.2012to Dec.2013. For each patient, the concentration of plasma D-dimer was tested and Grace risk scores were caculated by using specific variables collected and at admission.Numbers of diseased coronary artery and Gensini scores were caculated according to the results of coronary angiography.Patients were classified into3categories(low,middle and high risk) according to GRACE risk scores.We analyzed the relationships between GRACE risk scores in each category or the concentration of plasma D-dimer and the coronary artery pathological changes. Random30patients who received negative results of conorary angiography were selected as a control group,and we compared their medical records with STEMI patients’.Results:Plasma concentration of D-dimer were higher in STEMI group (709.20±43.93)ug/L than in control group(275.67±21.56)ug/L(P<0.01). Gensini scores were also higher in STEMI group (57.19±3.24) than in control group(1.87±0.27)(P<0.01).The relationship between concentration of plasma D-dimer and the severity coronary artery stenosis were analyzed(The correlation coefficient was0.692)(P<0.01).The relationships between GRACE risk score and the extent or severity coronary artery stenosis were also analyzed(The correlation coefficient were0.411,0.295,respectively)(P<0.01). There were statistically significant differences in the extent or severity coronary artery stenosis among three different GRACE risk groups(P<0.05).One-vessel lesion was more often found in patients with low risk group and three-vessel lesions was more often found in patients with high risk group by GRACE risk scores.Comparing with the concentration of plasma D-dimer,GRACE scoring system has a higher accuracy in predicting multivessel coronary artery disease.Conclusion:There are good relationships between the GRACE risk scores or concentration of plasma D-dimer and the angiographic extent and severity of coronary artery disease in patients with acute ST-segment elevation myocardial infraction.Both GRACE risk score and plasma D-dimer for assessment of the coronary stenotic severity have the important prognostic value.