The Effect of GRACE Scores on Prediction of 30-day Cardiovascular Adverse Events in Patients with Acute Chest Pain
American Journal of Clinical and Experimental Medicine
Volume 8, Issue 1, January 2020, Pages: 1-5
Received: Jan. 31, 2020; Accepted: Feb. 18, 2020; Published: Feb. 26, 2020
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Authors
Zhenhua Huang, Emergency Department, The First Affiliated Hospital of Sun Sat-sen University, Guangzhou, China
Qianlin Gu, Emergency Department, The First Affiliated Hospital of Sun Sat-sen University, Guangzhou, China
Hong Zhan, Emergency Department, The First Affiliated Hospital of Sun Sat-sen University, Guangzhou, China
Zhen Yang, Emergency Department, The First Affiliated Hospital of Sun Sat-sen University, Guangzhou, China
Yuee Chen, Emergency Department, The First Affiliated Hospital of Sun Sat-sen University, Guangzhou, China
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Abstract
To investigate the effect of GRACE scores on prediction of 30-day cardiovascular adverse events in acute chest pain patients. A prospective, observational analysis was conducted in the patients with acute chest pain in Emergency Department (ED) from January 1, 2016 through January 1, 2017. Data including characteristics and GRACE scores were collected. All causes leading to MACE were followed up at 30th day after the onset of acute chest pain. Among a total of 600 patients presenting with acute chest pain enrolled in this study, 302 were male (50.3%) and 298 were female (49.7%). The range of age was 20-80 years old. During follow-up period, 102 patients had MACE, 498 patients had no MACE. When compared with non-MACE group, factors including number of Smoker, Hypercholesterolemia, Diabetes, Hypercholesterolemia and patients admitted in CCU as well as GRACE scores, were significantly higher in MACE group (P<0.05). The predictive ROC curve area of GRACE scores in 30-day MACE was 0.739 (0.687 to 0.791). The probability of 30-day cardiovascular adverse events in various GRACE score risk stratification was 2.0% (low-risk), 5.33% (medium-risk), and 9.67% (high-risk), respectively. The GRACE score was a useful predictor to the occurrence of 30-day cardiovascular adverse events in acute chest pain patients. Patients with low GRACE score risk stratification have a low risk of 30-day MACE, which may be able to convey risk quickly and efficiently.
Keywords
GRACE Scores, Acute Chest Pain, Risk Stratification, Cardiovascular Adverse Events
To cite this article
Zhenhua Huang, Qianlin Gu, Hong Zhan, Zhen Yang, Yuee Chen, The Effect of GRACE Scores on Prediction of 30-day Cardiovascular Adverse Events in Patients with Acute Chest Pain, American Journal of Clinical and Experimental Medicine. Vol. 8, No. 1, 2020, pp. 1-5. doi: 10.11648/j.ajcem.20200801.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Poldervaart JM, Langedijk M, Backus BE et al. Comparison of the GRACE, HEART and TIMI Score to Predict Major Adverse Cardiac Events in Chest Pain Patients at the Emergency Department. Int J Cardiol. 2017; 227: 656-661.
[2]
Rahko PS. Rapid Evaluation of Chest Pain in the Emergency Department. Jama Intern Med. 2014; 174 (1): 59-60.
[3]
Holly J, Fuller M, Hamilton D et al. Prospective Evaluation of the Use of the Thrombolysis in Myocardial Infarction Score as a Risk Stratification Tool for Chest Pain Patients Admitted to an ED Observation Unit. Am J Emerg Med. 2013; 31 (1): 185-189.
[4]
Sakamoto JT, Liu N, Koh ZX et al. Comparing HEART, TIMI, and GRACE Scores for Prediction of 30-Day Major Adverse Cardiac Events in High Acuity Chest Pain Patients in the Emergency Department. Int J Cardiol. 2016; 221: 759-764.
[5]
Granger C B, Goldberg R J, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events. [J]. Arch Intern Med. 2003; 163 (19): 2345-2353.
[6]
Six A J, Backus B E, Kelder J C. Chest pain in the emergency room: value of the HEART score. [J]. Neth Heart J. 2008; 16 (6): 191-196.
[7]
Cotterill PG, Deb P, Shrank WH, Pines JM. Variation in Chest Pain Emergency Department Admission Rates and Acute Myocardial Infarction and Death within 30 Days in the Medicare Population. Acad Emerg Med. 2015; 22 (8): 955-964.
[8]
Ornato JP. Chest Pain Emergency Centers: Improving Acute Myocardial Infarction Care. Clin Cardiol. 1999; 8 Suppl: V3-9.
[9]
S L, L S, L S, et al. Different Causes of Death in Patients with Myocardial Infarction Type 1, Type 2, and Myocardial Injury. Am J Med. 2018; 131 (5): 548-554.
[10]
Roberts Lara N., Whyte Martin B., Arya Roopen. Pulmonary embolism mortality trends in the European region-too good to be true? Lancet Respir Med. 2020; 8 (1), e2.
[11]
E M. Half of patients with acute aortic dissection in England die before reaching a specialist centre. BMJ (Clinical research ed.). 2020; 368: m304.
[12]
Zhou B, Zu L, Mi L, et al. An analysis of patients receiving emergency CAG without PCI and the value of GRACE score in predicting PCI possibilities in NSTE-ACS patients. [J]. J Geriatr Cardiol., 2015, 12 (3): 246-250.
[13]
Ang DS, Wei L, Kao MP, et al. A comparison between B-type natriuretic peptide, global registry of acute coronary events (GRACE) score and their combination in ACS risk stratification. Heart, 2009; 95 (22): 1836-42.
[14]
Reaney PDW, Elliott HI, Noman A, Cooper JG. Risk Stratifying Chest Pain Patients in the Emergency Department Using HEART, GRACE and TIMI Scores, with a Single Contemporary Troponin Result, to Predict Major Adverse Cardiac Events. Emerg Med J. 2018; 7: 420-7.
[15]
Backus BE, Six AJ, Kelder JC et al. A Prospective Validation of the HEART Score for Chest Pain Patients at the Emergency Department. Int J Cardiol. 2013; 3: 2153-8.
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