GIÁ TRỊ TIÊN LƯỢNG CỦA THANG ĐIỂM GRACE TRÊN BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP CÓ TỔN THƯƠNG NHIỀU NHÁNH MẠCH VÀNH

Abstract

Introduction: Multivessel coronary artery disease is commonly observed in patients hospitalized for myocardial infarction and is associated with a worse prognosis compared to those with single-vessel disease. The GRACE score is used to assess the risk of all-cause mortality in both the short- and long-term among patients with acute myocardial infarction. In Vietnam, there have been limited studies evaluating the potential of the GRACE score in predicting major adverse cardiovascular events (MACE) in patients with acute myocardial infarction, particularly in those with multivessel coronary artery disease. Therefore, we conducted this study. Objective: To investigate the prognostic value of the GRACE score in predicting major adverse cardiovascular events in patients with acute myocardial infarction and multivessel coronary artery disease. Subjects: Patients with acute myocardial infarction and multivessel coronary artery disease treated at the Interventional Cardiology Department, Chợ Rẫy Hospital, from May 2020 to May 2023. Methods: A retrospective, cross-sectional descriptive study. Results: A total of 157 patients meeting the inclusion criteria were collected, with a mean age of 66.0 ± 9.8 years. Males were predominant, with a male-to-female ratio of 3.6:1. Hypertension and diabetes mellitus were the most common comorbidities, with prevalence rates of 82.8% and 22.9%, respectively. ST-elevation myocardial infarction accounted for 58.0% of cases. The median GRACE score in the study population was 126 (112–143). The in-hospital MACE rate was 10.8%, with cardiogenic shock being the most common event (88.2%), followed by stroke (11.8%). A GRACE score cutoff of 161 demonstrated good predictive ability for MACE, with an AUC of 0.94, sensitivity of 82.3%, and specificity of 94.3%. Each additional point in the GRACE score was associated with a 5% increase in the incidence of MACE. Conclusion: The in-hospital MACE rate in patients with acute myocardial infarction and multivessel coronary artery disease was 10.8%. The GRACE score was significantly associated with MACE, with a cutoff score of 161 providing strong predictive capability (AUC = 0.94).