Relation Between The GRACE Score And Severity Of Atherosclerosis In Suspected Acute Coronary Syndrome

Objective:The aim of the present study was to evaluate the relationship between the Global Registry of Acute Coronary Events(GRACE) score and severity of coronary artery disease angiographically evaluated by Gensini score in patients with non-ST-elevation acute coronary syndrome.Methods:A total of 102 patients with non-ST-elevation acute coronary syndrome were enrolled to the study. Based on the GRACE risk score classification system, the patients were divided into low-(n = 63, 61.8%), intermediate-(n = 30, 29.4%), and high-(n = 9, 8.8%)risk groups. All patients underwent coronary angiography within five days after admission.Results:The Gensini scores were 0(0,10) in the low-risk group, 5.3(0,20.6) in the intermediate-risk group, and 38.5(12.3,57.8) in the high-risk group(p < 0.001). The low-risk group was significantly different from the high-risk group(p < 0.005), and the difference from the intermediate-risk group almost reached significance. Normal,noncritical, one and two, or multivessel disease were identified in 43(42.2%), 26(25.5%),17(16.7%), and 16(15.7%) patients, respectively. The high-risk group was significantly different from the low-risk group(p < 0.001). GRACE score showed significant correlation with respective angiographic Gensini scores by Spearman correlation(r =0.334, p< 0.001).Twenty-five patients were diabetic(24.5%), eight of them had normal coronary arteries(24.5%) and seven had multivessel disease(28%). Subgroup analysis of our study suggested that there was no significant difference of Gensini score between patients with diabetes and non-diabetics(10.5(0,43.5)vs3(0,12),p=0.074).Conclusion:Our study demonstrates that the GRACE score has significant value for assessing the severity and extent of coronary artery stenosis in patients with non-ST-elevation acute coronary syndrome. In general, according to the results of the present study, patients with high GRACE score have more severe CAD, therefore angiography is important in the first24 h for early intervention in these patients.