Predictors of major adverse cardiovascular events within six- months post-ST elevation myocardial infarction using GRACE risk score
Keywords:
GRACE risk score, ST elevation myocardial infarction, major adverse cardiovascular eventsAbstract
This analytical, prospective study aimed to determine risk level and predictors for major adverse cardiovascular events using the Otago-Southland Global Registry of Acute Coronary Events (GRACE) risk score. Eligible 181 STEMI patients who admitted at a 600-bed tertiary hospital from October, 2017 to March, 2018 were recruited. Logistic regression was used to determine the predictors of major adverse cardiovascular events.
Results:The higher GRACE scores were associated significantly with major adverse cardiovascular events (Chi-square 14.04, p = 0.001). An approximate 13-fold increment in mortality risk was found in STEMI patients with moderate scores risk (OR 13.6, 95%Cl 1.75-106.48) and a 22 fold increase in those with severe scores (OR 22.5, 95%Cl 2.75-185.4). The final multivariate model showed that nine risk factors could significantly explained for 86.2% (p = 0.001) of mortality risk. An increment in mortality risk was found in STEMI patients with aged > 60 years, previous myocardial ischemia, heart rate at ER of > 90 beat per minute, systolic blood pressure at ER of < 160 mmHg, serum creatinine of > 0.8 mg/dl, a history of heart failure, elevated cardiac enzymes, and post percutaneous coronary intervention.
Using the GRACE risk score can be prognostic a major adverse cardiovascular event for the first
six-month after discharge. Patients with STEMI who had moderate-to-severe GRACE risk scores require further developed specific health care and follow-up system in order to prevent the major adverse cardiovascular events.
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