The predictive value of GRACE risk score on the left ventricular ejection fraction after acute anterior ST-segment myocardial infarction
Abstract
Purpose: The aim of the study is to investigate the predictive value of GRACE score for left ventricular ejection fraction (LVEF) after acute anterior segment acute myocardial infarction (AMI). Despite rapid and complete reperfusion in AMI, inadequate recovery of left ventricular function may result in a decrease in LVEF.
Materials and Methods: We retrospectively analyzed 712 patients presented with AMI and 290 patients were included. Patients were divided into two groups according to LVEF and a value <50% was defined as depressed EF group (group 1), a value ≥50% was defined as preserved EF group (group 2). The GRACE risk scores of all patients were calculated.
Results: 132 patients were included in the group 1, 158 patients were included in the group 2. In-hospital death GRACE risk score and in-hospital death/MI GRACE risk score were higher in group 1. A significant negative correlation was found between risk scores and LVEF. In multivariate regression analysis, in-hospital death risk score, and in-hospital death/MI risk score were found to be independently predictors of depressed LVEF.
Conclusion: GRACE risk score has a clinically important role predicting depressed LVEF in acute anterior segment AMI patients treated with primary PCI.
Keywords
risk stratification,left ventricular function,acute myocardial infarction,, heart failure
Kaynakça
- 1. Sanderson JE, Tse TF. Heart failure: a global disease requiring a global response. Heart. 2003;89:585-6.
- 2. Hung J, Teng TH, Finn J, Knuiman M, Briffa T, Stewart S et al. Trends from 1996 to 2007 in incidence and mortality outcomes of heart failure after acute myocardial infarction: a population-based study of 20,812 patients with first acute myocardial infarction in western Australia. J Am Heart Assoc. 2013;2:e000172.
- 3. Jhund PS, McMurray JJ. Heart failure after acute myocardial infarction: a lost battle in the war on heart failure. Circulation. 2008;118:2019-21.
- 4. Bigger Jr JT, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984;69:250-58.
- 5. Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR, Casey DE et al. 2012 ACCF/AHA Focused Update of the Guideline or the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Diretrizes 2012 Writing Committee Members. Circulation. 2012;126:875-910.
- 6. Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST segment elevation of the European Society of Cardiology. Eur Heart J. 2011;32:2999-3054.
- 7. Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163:2345-53.
- 8. Gibson CM, Cannon CP, Daley WL, Dodge Jr JT, Alexander Jr B, Marble SJ et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996;93:879-88.
- 9. Gheorghiade M, Sopko G, De Luca L, Velazquez EJ, Parker JD, Binkley PF et al. Navigating the crossroads of coronary artery disease and heart failure. Circulation. 2006;114:1202-13.
- 10. Nestico PF, Hakki AH, Iskandrian AS. Left ventricular dilatation. Prognostic value in severe left ventricular dysfunction secondary to coronary artery disease. Chest. 1985;88:215-20.
