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To investigate the effect of GRACE scores on the risk stratification of acute coronary syndrome and the prediction of 30-day cardiovascular adverse events in acute chest pain patients.
Using prospective observational study method, the patients with acute chest pain in ED, characteristics and GRACE scores were collected. All causes leading to MACE were followed up at 30 days by Health Insurance Information System and call interview.
Total 209 patients (65.28 ± 16.85 years, 47.37% female) presented with acute chest pain were enrolled. BMI, coronary heart disease, myocardial infarction history, hyperlipidemia, in-patient number, in-patient CCU number and GRACE scores were significantly higher in ACS group than in non-ACS group (P<0.05). Compared with non-ACS group, GRACE scores was significantly higher in NSTEMI group and STEMI group (P<0.05). The GRACE scores (136.86 ± 36.8) in the AMI group were significant higher than that in the UA group (112.72 ± 21.8) (P<0.05). The predictive ROC curve area of GRACE scores in acute chest pain ACS was 0.695 (95% CI: 0.622 to 0.767). When the GRACE score reached 118 points, the sensitivity and specificity were 0.60 and 0.72, respectively. And the ROC curve area of GRACE scores within 30 days MACE was predicted to be 0.819 (0.735 to 0.902), and a sensitivity is 0.92 and a specificity is 0.65. The probability of 30-day cardiovascular adverse events was beyond 108 points (1.0%), 108 to 140 points (6.0%), above 140 points (18.92%).
The GRACE score had potential predictive effect on ACS risk stratification and 30-day cardiovascular adverse events in acute chest pain patients.