Prognostic value of the GRACE discharge score for predicting the mortality of patients with stable coronary artery disease who underwent percutaneous coronary intervention.

OBJECTIVES: To assess the predictive value of the Global Registry of Acute Coronary Events (GRACE) discharge score for patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention (PCI). BACKGROUND: The GRACE score is widely used for predicting the mortality of acute coronary syndrome patients. However, the predictive value of SCAD has not been sufficiently studied. METHODS: We studied 4,293 consecutive patients with SCAD who underwent PCI between January 2013 and December 2013. The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS: Among 3,915 patients with SCAD following PCI, there were 38 deaths and 394 MACCE during 2 years of follow-up. The GRACE discharge score was significantly higher for patients who died than for those who survived (86.97 ± 23.27 vs. 71.07 ± 19.84; p < .001). Risk stratification of the GRACE score indicated that the mortality risk of the intermediate-risk and high-risk groups were 3.23-fold (hazard ratio [HR], 3.23; range, 1.59-6.55; p = .001) and 15.31-fold higher (HR, 15.31; range, 4.43-51.62; p < .001), respectively, than that of the low-risk group. The MACCE risk for the intermediate-risk and high-risk groups were 1.28-fold (HR, 1.28; range, 1.02-1.62; p = .037) and 2.42-fold higher (HR, 2.42; range, 1.20-4.88; p = .014), respectively. The GRACE discharge score had prognostic value for mortality (area under the receiver operating characteristic curve, 0.692; p < .001). CONCLUSIONS: The GRACE discharge score is valuable for the risk stratification of death and MACCE, as well as for the prognosis to mortality for SCAD patients who have undergone PCI.

Duke Scholars

Author Ying Xian Neurology, Neurocritical Care