scholarly journals Association of GRACE Risk Score with Coronary Artery Disease Complexity in Patients with Acute Coronary Syndrome

2021 ◽  
Vol 10 (10) ◽  
pp. 2210
Author(s):  
Georgios Sofidis ◽  
Nikolaos Otountzidis ◽  
Nikolaos Stalikas ◽  
Efstratios Karagiannidis ◽  
Andreas S. Papazoglou ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Syntax Score ◽  
Heart Team ◽  
Characteristic Analysis ◽  
Positive Correlation ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Grace Score

The GRACE score constitutes a useful tool for risk stratification in patients with acute coronary syndrome (ACS), while the SYNTAX score determines the complexity of coronary artery disease (CAD). This study sought to correlate these scores and assess the accuracy of the GRACE score in predicting the extent of CAD. A total of 539 patients with ACS undergoing coronary angiography were included in this analysis. The patients were classified into those with a SYNTAX score < 33 and a SYNTAX score ≥ 33. Spearman’s correlation and receiver operator characteristic analysis were conducted to investigate the role of the GRACE score as a predictor of the SYNTAX score. There was a significantly positive correlation between the SYNTAX and the GRACE scores (r = 0.32, p < 0.001). The GRACE score predicted severe CAD (SYNTAX ≥ 33) moderately well (the area under the curve was 0.595 (0.522–0.667)). A GRACE score of 126 was documented as the optimal cut-off for the prediction of a SYNTAX score ≥ 33 (sensitivity = 53.5% and specificity = 66%). Therefore, our study reports a significantly positive correlation between the GRACE and the SYNTAX score in patients with ACS. Notably, NSTEMI patients with a high-risk coronary anatomy have higher calculated GRACE scores. A multidisciplinary approach by a heart team could possibly alter the therapeutic approach and management in patients presenting with ACS and a high calculated GRACE score.

The Association Between Serum Procalcitonin Levels and Severity of Coronary Artery Disease Assessed by SYNTAX Score in Patients With Acute Coronary Syndrome

Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Ahmet Göktuğ Ertem ◽  
Tolga Han Efe ◽  
Çağrı Yayla ◽  
Mehmet Kadri Akboğa ◽  
Burak Açar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Inflammatory Marker ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Syntax Score ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Artery Disease

The SYNTAX score (SX score) is a useful score for assessing the severity of coronary artery disease (CAD). Previous studies have demonstrated a close relationship between SX score and inflammation. Procalcitonin (PCT) is an early inflammatory marker, especially during sepsis. Thus, in this study, we aimed to investigate the relationship between SX score and serum PCT levels. A total of 545 patients were enrolled in this prospective cross-sectional study and were divided into 2 subgroups, according to their SX score. Serum PCT and high-sensitivity C-reactive protein levels were measured. Serum PCT levels were higher in the high SX score group compared to the low–intermediate SX score group ( P < .001). Serum PCT levels were an independent predictor of a high SX score in patients with acute coronary syndrome ( P = .001). As patients with a higher SX score had increased serum PCT levels on admission, serum PCT may be useful for identifying patients with severe CAD.

scholarly journals ST Segment Depression in 12 lead ECG and Severity of Coronary Artery Disease in Non-ST segment elevation Acute Coronary Syndrome

2017 ◽  
Vol 9 (2) ◽  
pp. 116-121
Author(s):  
Mohammad Emdadul Hoque Miah ◽  
Abul Hussain Khan Chowdhury ◽  
Khandaker Qamrul Islam ◽  
Mir Jamaluddin ◽  
Shakil Ghafur ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Positive Correlation ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease ◽  
Vessel Score

Background: Patients of non-ST segment elevation acute coronary syndrome (NSTE ACS) is a large group who gets admitted in coronary care units. 12-lead electrocardiogram (ECG) provides the simple available and earliest objective information for risk stratification of NSTEACS. We tried to find out the association between magnitude of ST segment depression and angiographic severity in NSTE ACS patients.Methods: This cross sectional study was carried out in patients with NSTE ACS patients admitted into and underwent coronary angiography. A total number of 105 consecutive patients were included in this study. ST segment depression was measured and categorized according to magnitude of ST segment depression into three groups as Group I: No (<1mm) ST segment depression, Group II: 1-2 mm ( e”1 to <2mm) ST segment depression and Group III: e” 2 mm ST segment depression. Cumulative sum of ST segment depression and number of leads in ST segment depression also measured in all ECG leads. Angiographic severity was assessed by vessel score and Friesinger index. Significant CAD was considered if Friesinger index was e” 5. Magnitude of ST segment depression was correlated with angiographic severity of coronary artery disease.Results: According to ‘Friesinger index’ 56(53.33%) patients had significant CAD and 49(46.66%) patients had insignificant CAD. Magnitude of ST segment depression found to have significant relationship with severity of coronary artery disease (p<0.001). Number of leads in ST segment depression also revealed positive correlation (r = 0.446; p<0.001). Positive correlation was also found between sum of the ST segment depression and Vessel score (r= 0.435; p<0.001).Conclusion: Magnitude of ST segment depression is positively correlated with the angiographic severity of coronary artery disease in non- ST segment elevation acute coronary syndrome.Cardiovasc. j. 2017; 9(2): 116-121

Admission Heart Rate Is Associated With Coronary Artery Disease Severity and Complexity in Patients With Acute Coronary Syndrome

Angiology ◽  
2019 ◽  
Vol 70 (8) ◽  
pp. 774-781 ◽  
Author(s):  
Xiaoteng Ma ◽  
Zhijian Wang ◽  
Jianlong Wang ◽  
Fang Liu ◽  
Dai Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Disease Severity ◽  
Plaque Burden ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Coronary Artery Disease Severity ◽  
Artery Disease

We evaluated the relationship between admission heart rate (HR) and coronary artery disease severity and complexity in patients with acute coronary syndrome (ACS). A total of 884 patients (mean age 59 [11] years, 24.7% female) who underwent coronary angiography for ACS and were treated with primary or selective percutaneous coronary intervention were included in this cross-sectional study. The measurement of admission HR was based on the first available resting electrocardiogram after admission. The SYNTAX score (SS) was calculated. Patients with an SS ≤ 22 (n = 538) were classified as the low SS group and those with an SS > 22 (n = 346) were classified as the intermediate-to-high SS group. Admission HR was greater in the intermediate-to-high SS group compared with the low SS group (75 [10] bpm vs 67 [8] bpm, P < .001). Admission HR was positively and significantly correlated with the SS ( r = 0.475, P < .001). After multivariate analysis, admission HR (per 1 standard deviation, ie, 10 bpm) remained an independent predictor of intermediate-to-high SS (odds ratio: 3.135, 95% confidence interval: 2.538-3.873, P < .001). Admission HR is independently and positively associated with the SS. Thus, elevated admission HR may be useful to identify patients with ACS with a high coronary atherosclerotic plaque burden.

scholarly journals The relationship between IL-6 levels and the angiographic severity of coronary artery disease following percutaneous coronary intervention in acute coronary syndrome patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Ling ◽  
Hairong Weng ◽  
Shengxing Tang
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Area Under The Curve ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Background The present investigation was developed for the exploration of the association between IL-6 levels and acute coronary syndrome (ACS) findings upon angiographic evaluation. Methods A retrospective review of 346 patients suffering from chest discomfort that underwent coronary angiography was performed. The SYNergy between Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score (SS) and SS II were used to gauge ACS severity, with ACS patients being stratified into two groups based on an SS value of 22 and the median SS II value. Associations between IL-6 levels and SS or SS II values were assessed through Spearman's correlation analyses, and independent predictors of intermediate-high SS or high SS II were identified via a multivariate logistic regression approach. A receiver operating characteristic (ROC) curve was employed to explore of the predictive value of IL-6 levels. Results IL-6 was positively correlated with both SS (r = 0.479, P < 0.001) and SS II (r = 0.305, P < 0.001). Moreover, IL-6 levels were independently predictive of intermediate-high SS and high SS II values. ROC curves further demonstrated that IL-6 was able to predict intermediate-high SS and high SS II, with area under the curve (AUC) values of 0.806 and 0.624, respectively. Conclusion IL-6 levels are closely linked to the extent of coronary artery disease in ACS patients undergoing percutaneous coronary intervention. IL-6 levels may thus serve as a valuable and non-invasive biomarker of high-risk ACS patients.

scholarly journals Do ANGPTL-4 and galectin-3 reflect the severity of coronary artery disease?

2017 ◽  
Vol 11 (10) ◽  
pp. 261-270 ◽  
Author(s):  
Luxitaa Goenka ◽  
Melvin George ◽  
Vishakha Singh ◽  
Amrita Jena ◽  
Deepika Seshadri ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Multivariate Analysis ◽  
Coronary Artery ◽  
Enzyme Linked Immunosorbent Assay ◽  
Correlation Relationship ◽  
Positive Correlation ◽  
Coronary Syndrome ◽  
Galectin 3 ◽  
Artery Disease ◽  
Grace Score

Background: Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity worldwide. We thereby sought to investigate whether the biomarkers, angiopoietin-like 4 (ANGPTL-4) and galectin-3, reflect the severity of CAD. Methods: Patients were screened based on inclusion/exclusion criteria and written informed consent was obtained from the patients. Serum ANGPTL-4 and galectin-3 was quantified using enzyme-linked immunosorbent assay (ELISA) and correlated with the Global Registry of Acute Coronary Events (GRACE) and GENSINI score using Spearman’s rank correlation coefficient and multivariate analysis. Results: A total of 226 patients consisting of ST-segment elevation myocardial infarction (STEMI), non-STEMI/unstable angina (USA), chronic stable angina (CSA) and normal controls (NCs) participated in the study. ANGPTL-4 and galectin-3 were significantly higher in CAD than the NC group. ANGPTL-4 showed significant negative correlation with GRACE score in acute coronary syndrome (ACS) ( r = −0.211, p = 0.03) patients. ANGPTL-4 showed significant positive correlation with serum creatinine ( r = 0.304, p = 0.056) and body mass index (BMI) ( r = 0.424, p = 0.009) in CSA patients. A modest positive correlation was observed between the serum galectin-3 levels and GRACE score ( r = 0.187, p = 0.055) in ACS patients. However, on multivariate analysis the positive correlation relationship between ANGPTL-4 and galectin-3 with the severity of CAD was not sustained. Conclusion: In conclusion, ANGPTL-4 and galectin-3 do not appear to have a promising role for assessing the severity of CAD. Nevertheless these biomarkers do warrant further exploration in improving the management of CAD.

P3580Impact of glucose-6-phosphate dehydrogenase deficiency on the extent and severity of coronary atherosclerosis in patients with acute coronary syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Montereggi ◽  
G D Sanna ◽  
G Corda ◽  
E Ponti ◽  
A Murgia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
G6pd Deficiency ◽  
Coronary Atherosclerosis ◽  
Study Groups ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract Background Studies in animal models and humans suggested that glucose-6-phosphate dehydrogenase (G6PD) deficiency, a genetically inherited condition causing haemolytic anemia, may be considered a risk factor for cardiovascular disease. It is currently unknown whether enzymatic activity may impact the extent and severity of coronary atherosclerosis in patients with acute myocardial infarction. This hypothesis was tested in a cohort of acute coronary syndrome (ACS) patients undergoing invasive management from Northern Sardinia, where the population prevalence of G6PD deficiency is the highest in the Mediterranean area. Methods The study was based on a prospective single-centre registry of consecutive ACS patients undergoing coronary angiography and subsequent percutaneous revascularization between January 2017 and December 2018, in which G6PD activity has been measured quantitatively using a biochemical assay based on G6PD/6GPD ratio in erythrocytes. Subjects were defined as deficient when the ratio was <0.80. The primary endpoint of the study was the severity of coronary artery disease as assessed by the SYNTAX I score at baseline angiography. Results Among the 466 enrolled patients, 41 (9%) showed G6PD deficiency. Patients with G6PD deficiency were less likely to have a history of dyslipidemia (27% vs 50%; p=0.005) or diabetes (12% vs 21%; p=0.105). As expected, at admission patients with deficiency had lower hemoglobin level (12.1 vs 13.7 g/dL; p=0.005) as compared with those without. By angiography, SYNTAX score resulted as 19±9 and 16±9 (p=0.039) in patients with and without G6PD deficiency; while the number of diseased (with >50% stenosis) vessels was 1.9 vs 1.6 (p=0.089) in the 2 study groups. Left main disease was detected in 15% and 7% (p=0.06) patients, respectively. G6PD deficiency emerged as an independent predictor of high SYNTAX score (OR=2.16, 95% CI 1.1–4.5; p=0.037). Angioplasty with coronary stenting of the culprit vessel was performed in all patients, while GP IIb/IIIa inhibitors were used in 30% and 14% (p=0.009) of patients with and without G6PD deficiency. Finally, in-hospital events were similar between the 2 study groups. Conclusions An increased extent and severity of coronary artery disease was observed in ACS patients with G6PD deficiency as compared with those without, despite the lower prevalence of “classic” cardiovascular risk factors.

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