scholarly journals Tp-e/QTc ratio, SYNTAX, and GRACE score in patients who underwent coronary angiography owing to acute coronary syndrome

2021 ◽  
Vol 25 (12) ◽  
pp. 887-895
Author(s):  
Kadriye Gayretli Yayla ◽  
◽  
Çağrı Yayla ◽  
Mehmet Akif Erdöl ◽  
Mustafa Karanfil ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Coronary Syndrome ◽  
Grace Score

scholarly journals Importance of Risk Assessment in Timing of Invasive Coronary Evaluation and Treatment of Patients With Non–ST‐Segment–Elevation Acute Coronary Syndrome: Insights From the VERDICT Trial

2021 ◽  
Author(s):  
Jawad H. Butt ◽  
Klaus F. Kofoed ◽  
Henning Kelbæk ◽  
Peter R. Hansen ◽  
Christian Torp‐Pedersen ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Invasive Coronary Angiography ◽  
Invasive Strategy ◽  
St Segment Elevation ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Grace Score

Background The optimal timing of invasive examination and treatment of high‐risk patients with non–ST‐segment–elevation acute coronary syndrome has not been established. We investigated the efficacy of early invasive coronary angiography compared with standard‐care invasive coronary angiography on the risk of all‐cause mortality according to the GRACE (Global Registry of Acute Coronary Events) risk score in a predefined subgroup analysis of the VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography) trial. Methods and Results Patients with clinical suspicion of non–ST‐segment–elevation acute coronary syndrome with ECG changes indicating new ischemia and/or elevated troponin, in whom invasive coronary angiography was clinically indicated and deemed logistically feasible within 12 hours, were eligible for inclusion. Patients were randomized 1:1 to an early (≤12 hours) or standard (48–72 hours) invasive strategy. The primary outcome of the present study was all‐cause mortality. Of 2147 patients randomized in the VERDICT trial, 2092 patients had an available GRACE risk score. Of these, 1021 (48.8%) patients had a GRACE score >140. During a median follow‐up of 4.1 years, 192 (18.8%) and 54 (5.0%) patients died in the high and low GRACE score groups, respectively. The risk of death with the early invasive strategy was increased in patients with a GRACE score ≤140 (hazard ratio [HR], 2.04 [95% CI, 1.16–3.59]), whereas there was a trend toward a decreased risk of death with the early invasive strategy in patients with a GRACE score >140 (HR, 0.83 [95% CI, 0.63–1.10]) ( P interaction =0.006). Conclusions In patients with non–ST‐segment–elevation acute coronary syndrome, we found a significant interaction between timing of invasive coronary angiography and GRACE score on the risk of death. Randomized clinical trials are warranted to establish the efficacy and safety among high‐risk and low‐risk patients with non–ST‐segment–elevation acute coronary syndrome. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02061891.

scholarly journals Usefulness of the PRECISE DAPT score as a predictor of ischaemic stroke after an acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Gonzalez Ferrero ◽  
B.A.A Alvarez Alvarez ◽  
C.C.A Cacho Antonio ◽  
M.P.D Perez Dominguez ◽  
P.A.M Antunez Muinos ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Ischaemic Stroke ◽  
Independent Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Funding Source ◽  
Independent Factor ◽  
Prediction Ability ◽  
Coronary Syndrome ◽  
Grace Score

Abstract Introduction Ischaemic stroke (IS) risk after acute coronary syndrome is increasing. The aim of our study was to evaluate the stroke rate in a multicentre study and to determine the prediction ability of the PRECISE DAPT score, added to the prediction power of the GRACE score, already demonstrated. Methods This was a retrospective study, carried out in two centres with 5916 patients, with ACS discharged between 2011 and 2017 (median 66±13 years, 27.7% women). The primary endpoint was the occurrence of ischaemic stroke and its risk during follow up (median 5.5, IQR 2.6–7.0). Results A multivariable logistic regression analysis was made, where GRACE (HR 1.01, IC 95% 1.00–1.02) and PRECISE DAPT score (HR 1.03, IC 95% 1.01–1.05) were both an independent predictor of ischaemic stroke after ACS, in a model adjusted by age and AF, which was found to be the independent factor with highest risk (HR 1.67, IC 95% 1.09–2.55). Conclusions GRACE and PRECISE DAPT scores are ischaemic stroke predictors used during follow-up for patients after acute coronary syndrome. We should use both of them not only trying to predict ischaemic/haemorrhagic risk respectively but also as ischaemic stroke predictors. Figure 1. AUC Curves Funding Acknowledgement Type of funding source: None

scholarly journals Association of GRACE Risk Score with Coronary Artery Disease Complexity in Patients with Acute Coronary Syndrome

2021 ◽  
Vol 10 (10) ◽  
pp. 2210
Author(s):  
Georgios Sofidis ◽  
Nikolaos Otountzidis ◽  
Nikolaos Stalikas ◽  
Efstratios Karagiannidis ◽  
Andreas S. Papazoglou ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Syntax Score ◽  
Heart Team ◽  
Characteristic Analysis ◽  
Positive Correlation ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Grace Score

The GRACE score constitutes a useful tool for risk stratification in patients with acute coronary syndrome (ACS), while the SYNTAX score determines the complexity of coronary artery disease (CAD). This study sought to correlate these scores and assess the accuracy of the GRACE score in predicting the extent of CAD. A total of 539 patients with ACS undergoing coronary angiography were included in this analysis. The patients were classified into those with a SYNTAX score < 33 and a SYNTAX score ≥ 33. Spearman’s correlation and receiver operator characteristic analysis were conducted to investigate the role of the GRACE score as a predictor of the SYNTAX score. There was a significantly positive correlation between the SYNTAX and the GRACE scores (r = 0.32, p < 0.001). The GRACE score predicted severe CAD (SYNTAX ≥ 33) moderately well (the area under the curve was 0.595 (0.522–0.667)). A GRACE score of 126 was documented as the optimal cut-off for the prediction of a SYNTAX score ≥ 33 (sensitivity = 53.5% and specificity = 66%). Therefore, our study reports a significantly positive correlation between the GRACE and the SYNTAX score in patients with ACS. Notably, NSTEMI patients with a high-risk coronary anatomy have higher calculated GRACE scores. A multidisciplinary approach by a heart team could possibly alter the therapeutic approach and management in patients presenting with ACS and a high calculated GRACE score.

scholarly journals THE RESULTS OF URGENT CORONARY ANGIOGRAPHY AND STENTING IN THE ACUTE CORONARY SYNDROME

2016 ◽  
Vol 26 (1) ◽  
pp. 098-121
Author(s):  
VI Davydkin ◽  
◽  
MD Romanov ◽  
MF Yerzin ◽  
AA Kovalev ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Coronary Syndrome

How Well Does the GRACE Score Perform in a New Zealand Acute Coronary Syndrome Cohort?

2012 ◽  
Vol 21 ◽  
pp. S41
Author(s):  
A. Lin ◽  
A. Mustafa ◽  
M. Lee ◽  
G. Devlin ◽  
I. Ternouth ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
New Zealand ◽  
Coronary Syndrome ◽  
Grace Score

Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Angiology ◽  
2018 ◽  
Vol 70 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Burak Açar ◽  
Ozcan Ozeke ◽  
Mustafa Karakurt ◽  
Yasin Ozen ◽  
Mustafa Bilal Özbay ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Coronary Atherosclerosis ◽  
Scoring Systems ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Atherosclerotic Burden ◽  
First Occurrence ◽  
And Control ◽  
The Impact

Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

scholarly journals Prognostic impact of alkaline phosphatase for in-hospital mortality in patients with acute coronary syndrome: a prospective cohort study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025648
Author(s):  
Tongtong Yu ◽  
Yundi Jiao ◽  
Jia Song ◽  
Dongxu He ◽  
Jiake Wu ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Continuous Variable ◽  
Prognostic Performance ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Grace Score ◽  
Multivariable Adjustment

ObjectivesAlkaline phosphatase (ALP) can promote vascular calcification, but the association between ALP and in-hospital mortality in patients with acute coronary syndrome (ACS) is not well defined.DesignA prospective cohort study.Setting and participantsA total of 6368 patients with ACS undergoing percutaneous coronary intervention (PCI) from 1 January 2010 to 31 December 2017 were analysed.Main outcome measuresIn-hospital mortality was used in this study.ResultsALP was analysed both as a continuous variable and according to three categories. After multivariable adjustment, in-hospital mortality was significantly higher in Tertile 3 group (ALP＞85 U/L) (OR: 2.399, 95% CI 1.080 to 5.333, p=0.032), compared with other two groups (Tertile 1: ＜66 U/L; Tertile 2: 66–85 U/L). When ALP was evaluated as a continuous variable, after multivariable adjustment, the ALP level was associated with an increased risk of in-hospital mortality (OR: 1.011, 95% CI 1.002 to 1.020, p=0.014). C-statistic of ALP for predicting in-hospital mortality was 0.630 (95% CI 0.618 to 0.642, p=0.001). The cut-off value was 72 U/L with a sensitivity of 0.764 and a specificity of 0.468. However, ALP could not significantly improve the prognostic performance of Global Registry of Acute Coronary Events (GRACE) score (GRACE score+ALP vs GRACE score: C-statistic: z=0.485, p=0.628; integrated discrimination improvement: 0.014, p=0.056; net reclassification improvement: 0.020, p=0.630).ConclusionsIn patients with ACS undergoing PCI, ALP was an independent predictor of in-hospital mortality. But it could not improve the prognostic performance of GRACE score.

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