Correlation of Clinical Risk Scores with Angiographic Extent of Coronary Artery Disease in Patients with Non ST-Elevation Myocardial Infarction/Unstable Angina and Their Effects on 6 Month Outcomes.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
BACKGROUND:Patients with non ST elevation acute myocardial infarction(NSTEMI) and unstable angina (UA) have a wide variation in their disease severity.Thus,risk stratification is essential for adequate clinical decision-making. The accuracy of the GRACE, TIMI and PURSUIT scores in predicting coronary disease with NSTEMI/UA has not been established. AIM:The aim of the study was to correlate clinical risk scores with angiographic extent of coronary artery disease(CAD) in patients with NSTEMI and UA and their sixmonth outcomes. METHODOLOGY: It is a single centre, prospective study conducted ina tertiaryhealth care centre atTirupati, Indiabetween June 2016 to May 2017.Four hundred patients with UA and NSTEMI were evaluated for presence of 6 clinical predictors and 3 risk scores were calculated.Major adverse cardiovascular events (MACE) at six month follow up were studied and correlated with clinical predictors and risk scores. RESULTS: Mean TIMI score was 3.04±0.97, mean PURSUIT score was 10.23±1.72 and mean GRACE score was 105.37±25.78.Mean Syntax score(SS) was 14.08±10.13.Pearson correlation analysis showed a moderate positive correlation of TIMI risk score with SS(r: 0.326;p<0.01), whereas PURSUIT(r:0.212;p<0.01)andGRACE(r:0.223;p<0.01) risk scores showed weak positive correlation. Significant association between SS and biomarker elevation (p=0.001), congestive heart failure(p=0.02) and ≥2 anginal episodes within 24 hrs(p=0.002) was found.There was no significant correlation between SS with MACE events(p=NS). The results showed statistically significant correlation between GRACE score and MACE (p=0.04). Out of the 6 clinical predictors only CHF(congestive heart failure) showed statistically significant correlation with MACE. CONCLUSION: Patients with higher scores in TIMI, GRACE and PURSUIT scoring systems had significantly greater angiographic disease, when compared to those with low scores. Presence of CHF, >2 anginal episodes within 24 hrs and presence of elevated biomarker are stronger predictors of extent of coronary artery disease.TIMI score had more correlation with SS. Presence of CHF and higher GRACE risk score carries a significant correlation with MACE at 6 month follow up.
Authors and Affiliations
Vinod kumar N, Rajasekhar D, Vanajakshamma V,, SreedharNaik K, Suresh T
Keywords
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- EP ID EP557959
- DOI 10.9790/0853-1803145559.
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