Relation between the GRACE score and severity of atherosclerosis in acute coronary syndrome

Background: Patients with non-ST-elevation acute coronary syndrome are heterogeneous in terms of clinical presentation and immediate- and long-term risk of death or non-fatal ischemic events. The aim of the present study was to evaluate the relationship between the Global Registry of Acute Coronary Events (GRACE) score and severity of coronary artery disease angiographically evaluated by Gensini score in patients with non-ST-elevation acute coronary syndrome. Methods: A total of 245 patients with non-ST-elevation acute coronary syndrome were enrolled to the study. Based on the GRACE risk score classification system, the patients were divided into low- (n = 97, 39.6%), intermediate- (n = 84, 343%), and high- (n = 64, 26.1%) risk groups. All patients underwent coronary angiography within five days after admission. Results: The Gensini scores were 26 +/- 29 in the low-risk group, 29 +/- 19 in the intermediate-risk group, and 38 +/- 23 in the high-risk group (p = 0.016). The low-risk group was significantly different from the high-risk group (p = 0.013), and the difference from the intermediate-risk group almost reached significance. Normal, noncritical, one and two, or multivessel disease were identified in 15 (6.1%), 31 (12.7%), 75 (30.6%), and 124 (50.6%) patients, respectively. The prevalence of multivessel disease was 28% in the low-risk group, 30% in the intermediate-risk group, and 42% in the high-risk group. The high-risk group was significantly different from the low-risk group (p < 0.01). Conclusion: Our study demonstrates that the GRACE score has significant value for assessing the severity and extent of coronary artery stenosis in patients with non-ST-elevation acute coronary syndrome. (C) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.