Predictive Value Of The Combined Assessment Of NT-proBNP, IMA And GRACE Score To The Short-term Prognosis In Patients With Acute Coronary Syndrome

BackgroundAcute coronary syndrome (ACS) refers to the unstable angina (UA),non-ST-segment elevation myocardial infarction (NSTEMI) andST-segment elevation myocardial infarction (STEMI). It is currentlyclinical common cardiovascular disease with acuteonset、rapidchangesand high mortality. The Predictive value of ACS Short-term prognosis (30days) has important significance for improving the prognosis of patients.Active、 fast and accurately treatment plan，brings patients thebiggest benefit, and has important value of clinical application. There isvery few research on the recent predictive value of ACS patients inclinical. At present the clinical commonly used risk score in theprediction of prognosis of ACS patients includes the Global AcuteCoronary Events risk score (GRACE), Myocardial Infarction,Thrombolysis treatment (TIMI), etc. Among which GRACE score isconsidered to be the most effective risk scores for current ACS patients.But GRACE score has the disadvantage that it cannot reflect the body neurohumoral factors and hemodynamic changes, which makes itimperfect in reflecting neurohumoral factors, hemodynamic changes, andgeneral overall situation of the factors affecting the prognosis ofindicators, limits its application in the complicated and severe clinicalsituations. Studies found that amino terminal brain natriuretic peptideprecursor(N-terminal pro-brain natriuretic peptide, NT-proBNP) hasimportant valuer minal brain natriuretic peptide precursor, which is animportant biochemical indicator that reflect the heart function, and it canbe used for the early diagnosis, treatment and prognosis of ACS,etc.Ischemia modified albumin (IMA) can be detected in the earlymyocardial ischemia, having certain specificity, high sensitivity, andrelating to the degree of myocardial ischemia. In2003, the United Statesfood and drug administration (FDA) had given the IMA high negativepredictive value for diagnosis of acute myocardial ischemia, and hadapproved it to exclude diagnosis of ACS.At present the combined assessment of NT-proBNP, IMA, andGRACE score about the prognosis in patients with ACS is rarely reported.The purpose of this paper is to research the predictive value of thecombined detection of NT-proBNP, IMA and GRACE Score to theshort-term prognosis value in patients with ACS.ObjectiveThe objective of this study is to research the predictive value of the combined detection of NT-proBNP, IMA and GRACE Score to theShort-term prognosis in patients with Acute Coronary Syndrome.Methods336patients were selected from the patients diagnosed with ACS inthe second hospital of JiLin university, Between January2013andDecember2014. Among them,163patients with unstable angina (UA)Non ST segment elevation myocardial infarction (NSTEMI) patients in67cases Patients with ST-elevation myocardial infarction (STEMI) in106cases. All the patients on admission to detect the plasmaNT-proBNP levels, IMA levels and GRACE risk score.The endpoint events: Including The major adverse cardiovascularevents (MACE)(myocardial infarction，the plan again revascularization,and cardiac death) the recurrence of angina pectoris,The heartfailure.We divided the patients into the event group and the event groupon the basis of whether observation and follow-up of patients havecardiac events. Through the comparison between multiple groups theshort-term prognosis predictive value of NT-proBNP, IMA and GRACEScore the patients with ACS. All data analysis by SPSS17.0software,Results with p <0.05think difference was statistically significant.Results1.336patients with ACS, the short-term (30days) cardiac eventsand GRACE risk was positively related to higher GRACE points, the greater the risk of cardiac events (P <0.005), and NT-proBNP,IMA andGRACE have correlations.2. The joint evaluation of the NT-proBNP, IMA, and GRACE aboutthe incidence of short-term cardiac events has the advantage of sensitivity,specificity, positive predictive value, and negative predictive value overthe pairwise joint and the single index.Conclusion1. An admission NT-proBNP levels of plasma, the levels of IMAand GRACE score can predict ACS patients Short-term prognosisrisk.2. The NT-proBNP, IMA and GRACE have correlations, and theycan improve the prognostic significance of cardiac events inpatients with ACS.