Clinical risk scores correlation with angiographic extent of coronary artery disease and their 6 month outcomes in patients with non ST-elevation myocardial infarction

摘要

Background: The accuracy of GRACE (Global Registry of AcuteCoronary Events), TIMI (Thrombolysis in Myocardial Infarction)and PURSUIT (Platelet Glycoprotein IIb-IIIa Receptor SuppressionUsing Integrilin Therapy) scores in predicting coronary artery disease(CAD) with non ST-elevation myocardial infarction (NSTEMI)and unstable angina (UA) has not been established. Our aim wasto correlate clinical risk scores with angiographic extent of CAD inthese patients and their 6 month outcomes.Methods: It is a single center, prospective study. Consecutive243 patients with UA (110) and NSTEMI (133) were evaluated for6 clinical predictors and 3 risk scores were calculated. All patientsunderwent coronary angiography (CAG) and the extent of CAD wasdetermined by Syntax Score (SS). The SSwascorrelated with clinicalpredictors and their major adverse cardiovascular events (MACE)at 6 month follow-up were assessed.Results: Mean age was 55.6±10.6 years with a male preponderance(66.2%). Hypertension was the major risk factor (50.6%).The mean ejection fraction was 56.2±8.1%. Mean risk scores werefound to be TIMI 3.0±1.1, PURSUIT 14.6±1.8, GRACE 100.1±25.6while mean SS was 13.2±10.4. Majority of the patients had leftanterior descending artery disease. Presence of CHF (p = 0.05) anduse of aspirin (p = 0.04) were stronger predictors of extent of CAD.A total of 112 patients underwent percutaneous coronary intervention(PCI) and 39 were referred for coronary artery bypassgrafting (CABG). We found significant correlation with GRACE andSS (p = 0.05, r = 0.17) and TIMI and SS (p = 0.03, r = 0.23). During the6 month follow-up, 3 patients died, 6 presented with NSTEMI and2 had repeat PCI, 4 had stroke and 2 had bleeding manifestations.There was a significant correlation between angiographic score andre-hospitalization (p = 0.01) and death (p < 0.001).