A long-term prognostic evaluation of patients with non-ST-segment elevation acute coronary syndrome by GRACE score

doi:10.3969/j.issn.1002-1949.2015.07.006

Abstract：Objective To determine the predictive value of GRACE score and SYNTAX score on the long -term prognosis of patients with non -ST -segment elevation acute coronary syndrome ( NSTE-ACS ) .Methods The data of 895 patients with NSTE -ACS between January 2009 and January 2014 were continuous follow -up analyzed , and their GRACE score was calculated .Patients were divided into three groups:Drug group ( n=463 ) , Stent group ( n=371 ) and CABG group ( n=61).Kaplan-Meier method was used for survival analysis , and Cox proportional hazards model was used to the univariate analysis .Area under curve ( AUC) of ROC analysis was used to compare the two methods.Results 895 cases of complete follow -up and a median follow -up of 4.02 years.In the GRACE score low risk group ( 0 to 88 ) , intermediate risk group ( 89 to 118 ) and high -risk group (>118), MACE rates were respectively 14.01%, 36.16% and 38.02%, there were significant differences between the groups (P<0.01), MACE incidence in the low-risk group was relatively low. The overall MACE incidence rates for the Drug group , Stent group and CABG group were 22 .89%, 42.43% and 45.90%, a significant difference between the three groups (P<0.001).The incidence of MACE in the Drug group was lower than the Stent group and the CABG group (P<0.001).ROC curve analysis, GRACE score on long -term prognosis of Drug group had diagnostic capabilities [ AUC =0.676, 95%CI (0.622, 0.730), P<0.01];and had no diagnosis ability in the Stent group combined CABG group [AUC =0.567, 95% CI (0.512, 0.622), P =0.17].Cox proportional regression analysis showed that GRACE score had an important value for the long -term prognosis of NSTE-ACS. Conclusion GRACE score has an important value for the long -term prognosis of NSTE -ACS. Because GRACE score not included the angiographic and led to its predictive value decreased .GRACE score can be more accurate for the long -term prognosis in the patients with NSTE -ACS (≥6 months ) under simple drug therapy , but with non-diagnostic capabilities for the patients under coronary stents or CABG treatment .