Optimization of GRACE Risk Stratification by N-Terminal Pro-B-Type Natriuretic Peptide Combined with D-dimer in Patients with Non-ST-elevation Myocardial Infarction. | Semantic Scholar (2024)

In Chinese patients with acute NSTEMI, higher D-dimer levels on admission suggest a poor long-term prognosis, and the receiver operating characteristic (ROC) analysis suggested that D- dimer levels were better than the Charlson Comorbidity Index in all-cause death.

In non-AF patients with NSTEMI, CHA2DS2-VASc and SYNTAX scores are useful for prognosis assessment and can be used to identify patients at higher risk for in-hospital mortality.

SII may be positively correlated with GRACE score, and the combination of the two accurately predicted the occurrence of short-term MACE in STEMI patients after percutaneous coronary intervention (PCI).

A predictive model was built including markers of inflammation and OS (MPO, IL-10, and hs-CRP) to identify patients with the most severe cardiac injury (combined EF below median and troponin above median values) and showed that the area under the ROC curve of this model to detect patients with low EF and high TnI was 0.67.

Both the GRACE risk score and the TyG index could be significant and independent predictors of clinical outcomes in ACS patients with T2DM after PCI and a combination of them could be enhanced predictions of clinical outcome in these patients.

In patients with ACS D-Dimer was associated with higher in-hospital and short/long-term complications and was also higher in patients with NR phenomenon, which may help to identify patients with residual thrombotic risk after ACS.

D-dimer was associated with higher in-hospital and short/long-term complications and was also higher in patients with no-reflow phenomenon, which may help to identify patients with residual thrombotic risk after ACS.

Assessment of myocardial ESLLAD by speckle-tracking echocardiography may be helpful in predicting high risk angiographic territory involvement in patients with NSTEMI and a higher value can be considered as a high risk parameter which may show benefit of an early invasive strategy versus a conservative approach.

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In patients with acute coronary syndrome referred for coronary angiography, combinations of biomarkers including hsTnT, NT-proBNP and hsCRP with the GRACE score enhanced risk discrimination.

This study is the first to provide simple algorithms that can be used by the practicing clinician to more precisely estimate risk in individual patients based on the GRACE score and a single biomarker measurement on admission, and shows that a single measurement of GDF-15 on admission markedly enhances the predictive value of the GR ACE score and provides moderate incremental information to a model including the GRace score and NT-proBNP.

In ACS, most but not all of the analyses suggest that BNP can predict cardiovascular events over and above the GRACE score, which implies that both the GRaces reflect somewhat different risk attributes when predicting adverse prognosis in ACS and their synergistic use can enhance risk stratification in ACS to a small but potentially useful extent.

Temporal changes in NT-proBNP and hs-CRP are quantitatively associated with future cardiovascular events, supporting their role in dynamic risk stratification of NSTEACS.

High D-dimer levels on admission and at discharge were associated with a higher risk of MACE and non-CABG major bleeding in STEMI patients undergoing pPCI and the predictive value for major adverse cardiovascular events (MACE), after 3year follow up was investigated.

Bomarkers can add prognostic information to the GRACE score even in the current era of high-sensitivity cardiac troponin assays, however the incremental information offered by individual biomarkers varies considerably, however.

The use of RSs revealed a fair to good discriminatory accuracy in predicting both short-term and long-term major adverse cardiac events in Asian patients with MI and the GRACERS was more accurate in predicting long- term mortality.

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