Association Between Clinical Risk Scores (GRACE, HEART) and Angiographic Disease Complexity Among Women with Non-ST Elevation Myocardial Infarction

Abstract

Objectives: To determine the correlation of GRACE score and HEART score with angiographic disease complexity, as indicated by SYNTAX score in females with NSTEMI.

Methodology: This cross-sectional study was conducted at Fauji Foundation Hospital, Rawalpindi in six months from June 2024 to November 2024. After informed consent, 170 females who presented with NSTEMI were enrolled by convenient sampling. The GRACE and HEART scores of the patients were calculated. The patients then underwent primary percutaneous coronary angiography and SYNTAX score was estimated to determine angiographic disease complexity. Patients were divided into two groups: Group I having SYNTAX score <33 and Group II with SYNTAX score >33. Correlation of GRACE and HEART scores was seen with the SYNTAX score. The statistical analysis was carried out by the Statistical Package of the Social Sciences (SPSS) version 25.

Results: There was a significant difference in age, diabetes mellitus and hypertension between the patients with SYNTAX score <33 and >33.A significant difference existed in GRACE and HEART scores between the two groups, with higher scores in patients with SYNTAX score >33. When the correlation was seen between GRACE Score and SYNTAX score, the Pearson correlation coefficient was 0.605 showing strong correlation and p-value was significant (0.001). The Pearson correlation coefficient was 0.508 for HEART and SYNTAX scores with moderate significant correlation (p-value=0.001).

Conclusion: There is a strong and significant correlation between GRACE and angiographic disease severity, as indicated by SYNTAX score. Similarly, the association between HEART and SYNTAX scores is moderately significant. The GRACE and HEART scores are significantly higher in patients with SYNTAX score >33.