两种评分系统对急性冠脉综合征患者不良事件预测价值比较

The comparison of two score system for the prediction of adverse events in patients with acute coronary syndrome

目的对比全球急性冠状动脉事件注册评分(global registry of acute coronary events,GRACE)与五因素(history&ECG&age&risks&troponin,HEART)评分对急性冠脉综合征(acute coronary syndrome,ACS)患者不良事件的预测价值.方法选取2016年7月—2017年6月经急诊入院的ACS患者395例,在发病12 h内入院行冠状动脉造影检查.收集患者一般资料、实验室相关检查.分别采用GRACE和HEART评分系统对患者进行风险评估,计算风险分层.随访患者发病后30 d、90 d内心血管不良事件发生情况,对比两种评分系统对急性冠脉综合征患者风险的预测价值.结果采用受试者工作曲线分析GRACE评分、HEART评分对急性冠脉综合征患者发病30 d内发生心血管不良事件的曲线下面积分别为0.738、0.736;90 d内发生心血管不良事件的曲线下面积(AUC)分别为0.669、0.683.结论两种评分系统对冠脉综合征高危患者发病30 d内病情危险性识别能力相同;急性冠脉综合征患者90 d风险预测中,HEART评分系统在预测高危患者、识别低危患者的适用性优于GRACE评分.

Objective To compare global registry of acute coronary events(GRACE)score and five factors(history&ECG&age&risks&troponin,HEART)score for predicting adverse events in patients with acute coronary syndrome(ACS).Methods A total of 395 patients with ACS were collected from July 2016 to June 2017 for a retrospective study.All were examined with coronary angiography within 12 hours of disease onset.We recorded patient’s general information and laboratory tests.The GEACE and HEART score were both used for risk assessment and then risk stratification was calculated.Major adverse cardiovascular events(MACE)were followed up by telephone within 30 days and 90 days of the onset.Compare the two score system in the prediction of risks in patients with ACS.Results The receiver operating curve(ROC)analysis showed that the area under the curve(AUC)of GRACE and HEART score for predicting the 30 days risk of MACE were 0.738 and 0.736 respectively.For predicting the 90 days risk of MACE,AUC of GRACE and HEART score were 0.669 and 0.683 respectively.Conclusion The GRACE and HEART score are consistent in identifying disease risk within 30 days of acute coronary syndrome onset.The HEART score is better than GRACE in predicting high risk and low risk patients within 90 days of the onset.