State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Neurology, Duke Clinical Research Institute, Durham, North Carolina.
Catheter Cardiovasc Interv. 2020 Feb;95 Suppl 1:550-557. doi: 10.1002/ccd.28719. Epub 2020 Jan 10.
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).
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.
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).
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).
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.
评估全球急性冠状动脉事件注册（GRACE）出院评分对经皮冠状动脉介入治疗（PCI）后稳定型冠状动脉疾病（SCAD）患者的预测价值。
GRACE 评分广泛用于预测急性冠状动脉综合征患者的死亡率。然而，SCAD 的预测价值尚未得到充分研究。
我们研究了 2013 年 1 月至 2013 年 12 月期间接受 PCI 的 4293 例连续 SCAD 患者。主要终点是全因死亡率，次要终点是主要不良心血管和脑血管事件（MACCE）。
在 3915 例接受 PCI 的 SCAD 患者中，有 38 例死亡，394 例 MACCE 在 2 年随访期间发生。死亡患者的 GRACE 出院评分明显高于存活患者（86.97±23.27 与 71.07±19.84；p<.001）。GRACE 评分的风险分层表明，中危和高危组的死亡率风险分别为 3.23 倍（危险比[HR]，3.23；范围，1.59-6.55；p=.001）和 15.31 倍（HR，15.31；范围，4.43-51.62；p<.001），高于低危组。中危和高危组的 MACCE 风险分别为 1.28 倍（HR，1.28；范围，1.02-1.62；p=.037）和 2.42 倍（HR，2.42；范围，1.20-4.88；p=.014）。GRACE 出院评分对死亡率具有预后价值（接受者操作特征曲线下面积，0.692；p<.001）。
GRACE 出院评分对 SCAD 患者 PCI 后死亡和 MACCE 的风险分层以及死亡率的预后具有重要价值。
