Supervisors info:
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική, ΕΚΠΑ
Κυρίτση Ελένη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΤΕΙ Αθήνας
Τούτουζας Κωνσταντίνος, Καθηγητής, Ιατρική, ΕΚΠΑ
Summary:
INTRODUCTION: Patients with acute coronary syndrome are heterogeneous in terms of clinical presentation and immediate –and long-term risk of death or non- fatal ischemic events.
The aim of present study is to evaluate the relationship between the Global Registry of Acute Coronary Events (GRACE) score and severity of coronary artery disease angiographically evaluated by SYNTAX score in patients with acute coronary syndrome
Methods:A total number of 134 patients were admitted to the emergency department of coronary unit of General Hospital at Aigiofrom January 2017 to September 2018, diagnosed as unstable angina or ST elevation myocardial infarction or non ST elevation infarction. For each patient, GRACE score was calculated by using variables collected at admission. Patients were classified into 3 categories low(1-102)intermediate(102- 123)high (>123).All patients underwent emergency, early or elective coronary angiography within three days of admission. SYNTAX score was used to evaluate the severity of Coronary Artery Disease(using the algorithm as described in detail on the SYNTAX score website Non critical coronary artery disease was defined as a < 50% stenosis in coronary arteries, multivessel coronary artery defined as the presence of a >50% stenosis in two or more major epicardial arteries or left main coronary artery disease. Statistical analyses were perfomed using SPSS for Windows 24. One way ANOVA test was used for statistical comparison of continuous variables between the groups. Chi-squqre test was used for comparison of categorical variables between the groups.
Results: The present analysis includes a total of 134 patients (30 women and 104 men) Mean age was 63,3+/-12 years. Based on the GRACE risk score the patients were divided as low (n=47,35%)intermediate (n=43,32%) high (n=44,32,83%).26,64% of patients diagnosed as STEMI ,56,71% as NSTEMI and 21,64% as Unstable Angina. Using ANOVA as the test of significance the mean angiographic SYNTAX score showed increasing trend from lower to higher GRACE risk groups.(p=0,001). SYNTAX score were 6,73+/- 5,75 in the low group,12,47+/-8,46 in the intermediate group and 22,65+/-10,87(mean values)
Normal, non critical ,one or two or multivessel disease were identified in 25(18,7%) 49(36,6%) 40(29,9%)and 20(14,9%)patients respectively. The prevalence of multivessel disease (two or three vessel diseased)was 17,2% in the low risk group. ,36,9% in the intermediate risk group and 77,3% in the high risk group. Using chi square test, the increase of GRACE score affects the number of diseased vessel (p<0,001)
Conclusion: Our study demonstrates that the GRACE score has modest value for assessment of severity and extent of the coronary artery stenosis in patients with ACS. Nevertheless, further studies with large number of patients are needed to confirm this conclusion
