Comparison of the prognostic significance of the complications according to short-term scales in patients with Non-ST-segment elevation acute coronary syndrome without percutaneous coronary intervention

Alnaser M., Sychev I. V., Pushkina Y.A, Goncharova L. N.

ABSTRACT

This study aimed to compare the short-term prognosis of fatal and nonfatal complications using GRACE (Global Registry of Acute Cardiac Events risk score), TIMI  (Thrombolysis In Myocardial Infarction), PREDICT (PREdicting risk of Death In Cardiac disease Tool), PURSUIT (Platelet Glycoprotein IIb-IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) and RECORD  scales in patients with Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) without percutaneous coronary intervention (PCI).

Methods. 122 patients admitted to the Mordovian Republican Central Clinical Hospital” with a referral diagnosis of NSTE-ACS were examined. The peculiarity of this sample is the absence of primary PCI while the patient was in the hospital. Absence of primary PCI was explained in 14 (11.5%) patients by the refusal of coronary angiography (CAG) (due to age), in 8 (6.5%) patients due to intolerance of contrast agent or analgesic medication. All other 100 patients from this group underwent CAG, where intact coronary vessels were detected in 27 (27%) patients, in 42 (42%) patients the degree of stenosis was less than 50% and in 31 (31%) patients (all patients with type 2 diabetes) a distal type of coronary lesion was detected.

Results. When comparing the effectiveness of prognostic significance of short-term fatal and nonfatal complications, as well as the prognosis assessment regardless of the type of adverse outcome in ACS patients without PCI, GRACE scale showed the highest sensitivity and specificity compared with short-term RECORD, PREDICT, TIMI and PURSUIT scales used in this study. The TIMI and RECORD scales showed efficacy of short-term prognosis only for fatal complications in this category of patients.

Conclusion. Taking into account the results of this study in NSTE-ACS patients without PCI, the GRACE scale was recommended to assess the prognostic significance of short-term complications regardless of the type of adverse outcome.

Keywords: NSTE-ACS without PCI, short-term prognostic scales — GRACE, RECORD, PREDICT, TIMI, PURSUIT.

For citation:

Alnaser M., Sychev I. V., Pushkina Y.A, Goncharova L. N.  Comparison of the prognostic significance of the complications according to short-term scales in patients with Non-ST-segment elevation acute coronary syndrome without percutaneous coronary intervention. International Journal of Heart and Vascular Disease. 2023. 11(38):23-30. DOI: 10.24412/2311-1623-2023-38-27-36