• NEWS . 03 Feb 2020
  • GRACE score useful for patients with SCAD after PCI

  • The Global Registry of Acute Coronary Events (GRACE) discharge score is valuable for patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI).
     
    In a prospective study of 4,293 patients with SCAD who underwent PCI in 2013, researchers in China evaluated the usefulness of the GRACE discharge score for out-of-hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) for 2 years after discharge. This is because the predictive value of the GRACE score for out-of-hospital long-term mortality rates and MACCE of patients with SCAD has not been sufficiently studied.

    After 378 patients had been excluded (for various reasons including not being discharged with dual antiplatelet therapy, loss at follow-up and in-hospital death), there were 38 deaths and 394 MACCE during 2 years of follow-up among the 3,915 remaining patients with SCAD after PCI. The GRACE discharge score was significantly higher for patients who died than for those who survived (86.97±23.27 vs 71.07±19.84; p<0.001). Risk stratification of the GRACE score indicated that the mortality risks of the intermediate-risk and high-risk groups were 3.23-fold (hazard ratio [HR], 3.23; range, 1.59–6.55; p=0.001) and 15.31-fold higher (HR, 15.31; range, 4.43–51.62; p<0.001), respectively, than that of the low-risk group. The MACCE risks for the intermediate-risk and high-risk groups were 1.28-fold (HR, 1.28; range, 1.02–1.62; p=0.037) and 2.42-fold higher (HR, 2.42; range, 1.20–4.88; p=0.014), respectively. The GRACE discharge score had prognostic value for mortality (area under the receiver operating characteristic curve, 0.692; p<0.001).

    The GRACE discharge score with risk stratification is valuable for predicting mortality and MACCE. Furthermore, the GRACE discharge score has prognostic value for 2-year out-of-hospital mortality, but not for MACCE. Therefore, the researchers suggested that the use of the GRACE score for patients with SCAD has a broader scope.

    Reference:
    Zhao X, et al. Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention. Catheter Cardiovasc Interv 2020. doi: 10.1002/ccd.28719. [Epub ahead of print]