Shaikh Muhammad Kashif, Hanif Bashir, Shaikh Kaleemullah, Khan Waqar, Parkash Jai
J Pak Med Assoc. 2014 Jul;64(7):807-11.
To validate the global registry of acute coronary event (grace) risk score in a Pakistani population at Tabba Heart Institute Karachi in patients with non ST-Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA).
In this prospective Observational registry study, 530 adults hospitalized patients with a diagnosis of Non-ST-Elevation Myocardial Infarction and unstable angina were enrolled between March 2012 and August 2012 at the Tabba Heart Institute, Karachi, Pakistan. For each patient, the grace risk score was calculated and its discrimination evaluated and correlated with in-hospital mortality using the Kendall's tau-b bivariate correlation test. Each patient was grouped either into high, intermediate or low risk groups according to their GRS.
A total of 530 patients with NSTEMI and UA were included; the overall mean grace risk score in our population was 131.87 +/- 41.56. The GRACE Risk Score showed good discrimination, with Area under the ROC curve of 0.803 (95% CI 0.705-0.902, P < 0.001). During the in-hospital stay, total of 19 (3.6%) patients died, and out of those 15 (8.4%) patients belonged to high risk group.
GRACE RS strongly validates the in-hospital mortality among our patient population presenting with a wide spectrum of complications. However, more multicentre registries on a larger population with long-term follow up are required to study detailed trends in our population.
在巴基斯坦卡拉奇塔巴心脏病研究所的非ST段抬高型心肌梗死（NSTEMI）和不稳定型心绞痛（UA）患者中验证急性冠状动脉事件全球注册研究（GRACE）风险评分。
在这项前瞻性观察性注册研究中，2012年3月至2012年8月期间，在巴基斯坦卡拉奇塔巴心脏病研究所招募了530例诊断为非ST段抬高型心肌梗死和不稳定型心绞痛的成年住院患者。为每位患者计算GRACE风险评分，并使用肯德尔tau-b双变量相关性检验评估其辨别力，并与住院死亡率进行相关性分析。根据GRACE风险评分，将每位患者分为高、中、低风险组。
共纳入530例NSTEMI和UA患者；我们研究人群的总体平均GRACE风险评分为131.87±41.56。GRACE风险评分显示出良好的辨别力，ROC曲线下面积为0.803（95%CI 0.705-0.902，P<0.001）。住院期间，共有19例（3.6%）患者死亡，其中15例（8.4%）属于高风险组。
GRACE风险评分有力地验证了我们研究人群中出现各种并发症患者的住院死亡率。然而，需要更多关于更大人群的多中心注册研究以及长期随访来研究我们人群中的详细趋势。
