Remnant cholesterol combined with GRACE scores for predicting prognosis in patients with non-ST-segment elevation acute coronary syndromes
Hua Xiaxia
Chai Meng
Li Xi
Yang Shupeng
Abstract：Objective To investigate the clinical value of remnant cholesterol(RC)combined with scores of Global Registry of Acute Coronary Event(GRACE)for predicting poor prognosis in patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS).Methods This study was designed as a single-center,retrospective investigation.NSTE-ACS patients were enrolled at Beijing Anzhen Hospital affiliated to Capital Medical University from Mar.2021 to July 2023.All patients were divided into 4groups based on quartiles of RC levels:low-RC group,moderate-RC group,moderate-high-RC group and high-RC group.The primary endpoint was defined as major adverse cardiovascular events(MACE),including all-cause death,non-fatal myocardial infarction and unplanned repeat revascularization,with a follow-up period of 3 y.The relationship among different RC levels,GRACE scores and MACE were reviewed by using Cox proportional hazards model.The relationship between RC(as a continuous variable)and MACE risk was discussed by employing restricted cubic spline(RCS)model.Receiver operating characteristic(ROC)curves were plotted to review the predictive performance of RC,GRACE scores and their combination for MACE events.The predictive value of different indicators was compared by using the area under the curve(AUC).Results A total of 667 NSTE-ACS patients were included.The results of Cox regression analysis showed that MACE risk was significantly higher in high-RC group than that in low-RC group,and MACE risk increased with higher GRACE scores.After adjusting for potential confounding factors,both RC levels and GRACE scores remained statistically significance in predicting MACE risk.The results of ROC curve analysis showed that the predictive power of RC combined with GRACE score(AUC=0.766)was superior to that of GRACE score alone(AUC=0.681)or RC value alone(AUC=0.678).Conclusion RC level and GRACE scores are correlated to MACE risk in NSTE-ACS patients.RC level combined with GRACE scores had a higher predictive value to poor prognosis in NSTE-ACS patients.
Keywords：Remnant cholesterolNon-ST-segment elevation acute coronary syndromesScores of Global Registry of Acute Coronary EventsMajor adverse cardiovascular events
Publication Date：2025-09-20
Online Publishing Date：2025-11-04(First online date of this platform, not the publication date of the document)
Pages：5( 1110-1114 )