Fujii Toshiharu, Suzuki Toshihiko, Torii Sho, Murakami Tsutomu, Nakano Masataka, Nakazawa Gaku, Masuda Naoki, Shinozaki Norihiko, Matsukage Takashi, Ogata Nobuhiko, Yoshimachi Fuminobu, Ikari Yuji
Department of Cardiology, Tokai University School of Medicine.
Circ J. 2014;78(12):2950-4. doi: 10.1253/circj.cj-14-0808. Epub 2014 Oct 6.
The purpose of the present study was to confirm the diagnostic accuracy of Global Registry of Acute Coronary Events (GRACE) risk score 1.0 (GRACE 1.0) and updated GRACE 1.0 (GRACE 2.0) for in-hospital and 360-day mortality in ST-elevation myocardial infarction (STEMI) in Japanese patients. GRACE 1.0 and GRACE 2.0 are the established predictive models in acute coronary syndrome, but their application to Japanese patients has not been fully verified. METHODS AND RESULTS: The present study retrospectively analyzed 412 consecutive STEMI patients who had undergone primary percutaneous coronary intervention from January 2006 to September 2011. All causes of death during hospitalization were examined to confirm the diagnostic accuracy of GRACE 1.0 on receiver operating characteristic (ROC) analysis. Similarly, all causes of death during the 360 days after hospitalization were analyzed to confirm the diagnostic accuracy of GRACE 2.0. The average GRACE 1.0 score was 175.8±50.9. In-hospital and 360-day mortality were 13.1% and 15.5%, respectively. Area under the ROC curve, which describes the diagnostic accuracy of the GRACE 1.0 predicted in-hospital mortality and the GRACE 2.0 predicted 360-day mortality, was as high as 0.95 and 0.92, respectively.
Both GRACE 1.0 and GRACE 2.0 had a high diagnostic accuracy for prediction of in-hospital and 360-day mortality in Japanese STEMI patients.
本研究的目的是确认全球急性冠状动脉事件注册研究（GRACE）风险评分1.0（GRACE 1.0）和更新后的GRACE 1.0（GRACE 2.0）对日本ST段抬高型心肌梗死（STEMI）患者院内及360天死亡率的诊断准确性。GRACE 1.0和GRACE 2.0是急性冠状动脉综合征中已确立的预测模型，但它们在日本患者中的应用尚未得到充分验证。
本研究回顾性分析了2006年1月至2011年9月期间连续412例行直接经皮冠状动脉介入治疗的STEMI患者。检查住院期间所有死亡原因，以通过受试者操作特征（ROC）分析确认GRACE 1.0的诊断准确性。同样，分析住院后360天内所有死亡原因，以确认GRACE 2.0的诊断准确性。GRACE 1.0评分的平均值为175.8±50.9。院内及360天死亡率分别为13.1%和15.5%。描述GRACE 1.0预测的院内死亡率和GRACE 2.0预测的360天死亡率诊断准确性的ROC曲线下面积分别高达0.95和0.92。
GRACE 1.0和GRACE 2.0对预测日本STEMI患者的院内及360天死亡率均具有较高的诊断准确性。
