Comparison of GRACE,CADC,and TIMI scores to evaluate major cardiac adverse events after percutaneous coronary intervention in patients with ST segment elevation myocardial infarction
Objective To compare the predictive values of the Global Registry of Acute Coronary Events(GRACE)risk scores,the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications(CADILLAC)trial scores,and the Thrombolysis In Myocardial Infarction(TIMI)scores for major adverse cardiac events(MACEs)in patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention.Methods A retrospective analysis was conducted on 80 STEMI patients diagnosed at the Affiliated People's Hospital of Ningbo University from January 2018 to January 2022,all of whom received percutaneous coronary intervention.The patients were followed up for 1-15 months with a median time of 7.5 months.MACEs,mainly including target vessel reconstruction,recurrent myocardial infarction,new heart failure,malignant arrhythmia,and cardiac death,were recorded.Results Of the 80 patients,MACEs occurred in 18 cases(22.5％,18/80)after percutaneous coronary intervention.Univariate analysis found that patients in the MACEs group had an increase in age,multiple vessel lesions,stent implantation length,peak and duration of troponin Ⅰ,and total ischemia time＞6 hours,which were significantly different from those in the non-MACEs group(P＜0.05).The MACEs group showed a significant increase in GRACE score[(136.5±30.4)scores],modified CADILLAC score[(11.2±3.4)score],and TIMI score[(5.7±1.5)scores]at 7 days after surgery.The percentage of patients with GRACE score high-risk[12/18(66.67％)],CADILLAC score high-risk[13/18(72.22％)],and TIMI score high-risk[11/18(61.11％)]increased significantly(x2=23.22,21.35,24.42,all P＜0.05).Increasing age,total ischemia time＞6 hours,GRACE score high-risk,CADILLAC score high-risk and TIMI score high-risk were all independent risk factors for MACEs at 1-year follow-up in STEMI patients(HR values were 1.079,2.037,3.562,3.421,and 3.236,respectively).The receiver operating characteristic curve showed that the area under the curve of GRACE score high-risk,CADILLAC score high-risk,and TIMI score high-risk for predicting MACEs were 0.816,0.823 and 0.803 respectively,with no statistically significant differences(P＞0.05).Conclusion The use of GRACE score,modified CADILLAC score,and TIMI score after percutaneous coronary intervention in STEMI patients has predictive value for major cardiac adverse events after percutaneous coronary intervention,and all three scores have good accuracy in predicting the risk of MACEs at 1-year follow-up.
ST elevation myocardial infarctionPercutaneous coronary interventionMechanical thrombolysisHeart failureTroponin
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