Comparison of the GRACE and TIMI Risk Scores in Predicting the Angiographic Severity of Coronary Artery Disease in Patients with non STelevation Myocardial Infarction

2017 ◽  
Vol 10 (1) ◽  
pp. 45-51
Author(s):  
Sharadindu Shekhar Roy ◽  
STM Abu Azam ◽  
Md Khalequzzaman ◽  
Mohammad Ullah ◽  
Samir Kumar Kundu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Roc Curve ◽  
Risk Scores ◽  
Cross Sectional ◽  
Timi Score ◽  
Artery Disease ◽  
Vessel Score ◽  
Grace Score

Background: The superiority of the GRACE and TIMI risk scores in predicting the angiographic severity of coronary artery disease in patients with non ST-elevation myocardial infarction (NSTEMI) has not yet been established. This study was done to compare the GRACE and TIMI risk scores in predicting the angiographic severity of coronary artery disease in this group of patients.Method: The cross sectional study done in the Department of Cardiology, NICVD, Dhaka. The patients admitted with NSTEMI were evaluated to calculate the GRACE and TIMI risk score from April, 2015 to April, 2016.Coronary angiogram was done during index hospitalization and the severity of the coronary artery disease was assessed by vessel score and Gensini score.Results: Of 115 patients assessed, a positive correlation of the vessel score and Gensini score was observed with both the GRACE and TIMI risk scores (p=<0.001) and the GRACE score (r=0.59) correlated better than the TIMI score (r=0.52). The GRACE score presented area under the Receiver Operating Characteristic (ROC) curve of 0.844(95% CI = 0.774 – 0.914) significantly superior to the area under the ROC curve of 0.752(95% CI =0.658– 0.846) of the TIMI score for the difference between the two scores.Conclusion: Both the GRACE and TIMI scores had good predictive value in predicting the severity of coronary artery disease in the patients with NSTEMI but when both the scores were compared, the GRACE score was found to be superior and correlated better with the severity of coronary artery disease.Cardiovasc. j. 2017; 10(1): 45-51

The association of opium with coronary artery disease

2007 ◽  
Vol 14 (5) ◽  
pp. 715-717 ◽  
Author(s):  
Saeed Sadeghian ◽  
Soodabeh Darvish ◽  
Gholamreza Davoodi ◽  
Mojtaba Salarifar ◽  
Mehran Mahmoodian ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Artery Disease ◽  
European Society Of Cardiology ◽  
Vessel Score ◽  
First Time

Background The effects of opium consumption on coronary artery disease are still unknown. Methods A cross-sectional study was conducted on 2405 patients admitted to the Angiographic Ward at Tehran Heart Center from 7 May 2005 to 13 August 2005. Results After adjusting for conventional cardiovascular risk factors, opium consumption was a significant risk factor for coronary artery disease ( P=0.01 and odds ratio = 1.8). Moreover, the amount of opium consumption was associated significantly with the severity of coronary atherosclerosis, as measured by clinical vessel score ( r=0.2, P=0.002). Conclusions To our knowledge, this is the first time that the adverse effects of opium consumption on coronary arteries was defined. Eur J Cardiovasc Prev Rehabil14:715-717 © 2007 The European Society of Cardiology

scholarly journals THE PREDICTIVE UTILITY OF GRACE SCORE FOR OBSTRUCTIVE CORONARY ARTERY DISEASE IN PATIENTS WITH NON ST ELEVATION MYOCARDIAL INFARCTION

2021 ◽  
Vol 54 (3) ◽  
pp. 239-243
Author(s):  
Haroon Ishaq ◽  
Bilal Akhtar ◽  
Mukesh Kumar ◽  
Ghulam Shabbir Shar ◽  
Abdul Hakeem ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Predictive Value ◽  
Independent Predictor ◽  
Obstructive Coronary Artery Disease ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Artery Disease ◽  
Grace Score

Objectives: The objective of this study was to determine the predictive value of GRACE score for predicting obstructive coronary artery disease in patients with non ST-segment elevation myocardial infarction (NSTEMI). Methodology: This cross-sectional study was conducted at the largest public sector cardiac care center of the Pakistan between January 2020 and June 2020. In this study, we included adult patients diagnosed with NSTEMI and correlation of GRACE score was assessed with angiographic finding of obstructive CAD defined as ≥50% stenosis in the left main or ≥70% stenosis in other coronary arteries. Results: A total of 227 patients were included in this study, out of whom 72.2% (164) were male patients and mean age was 55.77 ± 9.15 years. Mean GRACE score was found to be 95.89 ± 21.15. On coronary angiography obstructive CAD was present in 84.6% (192) of the patients. Area under the cure for predicting obstructive CAD was 0.669 [0.552 to 0.785]. The optimal cutoff value of GRACE score was ≥ 84 with sensitivity of 79.7% [73.3% to 85.1%] and specificity of 57.1% [39.3% to 73.7%]. GRACE score of ≥ 84 was found to be an independent predictor of obstructive CAD with odds ratio of 4.33 [1.61 - 11.64; p=0.004] adjusted for gender, age, hypertension, diabetes, family history of CAD, and smoking. Conclusion: GRACE score has a moderate predictive value in predicting obstructive CAD in patients with NSTEMI. The optimal cutoff value of 84 is an independent predictor with good sensitivity but moderate specificity in predicting obstructive CAD.

scholarly journals TIMI RISK SCORES

2015 ◽  
Vol 22 (12) ◽  
pp. 1569-1573
Author(s):  
Muhammad Ijaz Bhatti ◽  
Usman Javed Iqbal ◽  
Nasir Iqbal
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Risk Scores ◽  
Vessel Coronary Artery Disease ◽  
Timi Score ◽  
St Elevation ◽  
Artery Disease ◽  
Timi Risk Score ◽  
Vessel Coronary Artery

Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predictsadverse clinical outcomes in patients with non–ST-elevation acute coronary syndromes(NSTEACS). Whether this score correlates with the coronary anatomy is unknown. Objective:To determine the frequency of low, moderate and high TIMI risk score in patients of NSTEACSand to compare the frequency of two vessel coronary artery disease on angiography withlow, moderate and high TIMI risk scores in patients of NSTE-ACS. Study design: This was across sectional study. Setting: Department of Cardiology, Gulab Devi Chest Hospital, Lahore.Duration: Six months. Patients and Methods: Total 170 patients were included in the study.Patients’ selection was done with the help of a pre-defined inclusion and exclusion criteria. TIMIrisk score was calculated for each patient and patients were categorized into low, moderate andhigh risk groups (as per operational definition). Patients were further evaluated with coronaryangiograms to assess the double vessel CAD. All angiographies were performed by a singlephysician. Data analysis was done on SPSS version 17. Results: Mean age of our patients was54.81±10.55 years. Gender distribution shows that there were 106(62%) male and 64(38%)female patients. TIMI score risk classification showed that among 50(29.4%) patients TIMI riskscore was low, among 107(62.9%) patients it was moderate and in 13(7.6%) patients it washigh. There were 105(62%) patients who had two vessel coronary artery disease. Among 105patients who had two vessel coronary artery disease, 25(23.8%) had low TIMI score, 69(65.7%)had moderate and 11(10.5%) of the patients had high TIMI score. Conclusion: In patientswith non-ST-elevation acute coronary syndrome undergoing cardiac catheterization, the TIMIrisk score is significantly associated with two vessel coronary artery disease. So it should berecommended that a routine invasive strategy be carried in patients with moderate or higherTIMI risk score.

scholarly journals KLRD1, FOSL2 and LILRB3 as potential biomarkers for plaques progression in acute myocardial infarction and stable coronary artery disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiang Zhang ◽  
Yue Zheng ◽  
Meng Ning ◽  
Tong Li
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Roc Curve ◽  
Stable Coronary Artery Disease ◽  
Linear Regression Analysis ◽  
Recurrent Event ◽  
System Response ◽  
Ppi Network ◽  
Artery Disease

Abstract Background Myocardial infarction (MI) contributes to high mortality and morbidity and can also accelerate atherosclerosis, thus inducing recurrent event due to status changing of coronary artery walls or plaques. The research aimed to investigate the differentially expressed genes (DEGs), which may be potential therapeutic targets for plaques progression in stable coronary artery disease (CAD) and ST-elevated MI (STEMI). Methods Two human datasets (GSE56885 and GSE59867) were analyzed by GEO2R and enrichment analysis was applied through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. To explore the seed genes, the protein–protein interaction (PPI) network was constructed and seed genes, as well as top30 ranking neighbours were screened out. To validate these findings, one human dataset GSE120521 was analyzed. Linear regression analysis and ROC curve were also performed to determine which seed genes above mentioned could be independent factors for plaques progression. Mice MI model and ELISA of seed genes were applied and ROC curve was also performed for in vivo validation. Results 169 DEGs and 573 DEGs were screened out in GSE56885 and GSE59867, respectively. Utilizing GO and KEGG analysis, these DEGs mainly enriched in immune system response and cytokines interaction. PPI network analysis was carried out and 19 seed genes were screened out. To validate these findings, GSE120521 was analyzed and three genes were demonstrated to be targets for plaques progression and stable CAD progression, including KLRD1, FOSL2 and LILRB3. KLRD1 and LILRB3 were demonstrated to be high-expressed at 1d after MI compared to SHAM group and FOSL2 expression was low-expressed at 1d and 1w. To investigate the diagnostic abilities of seed genes, ROC analysis was applied and the AUCs of KLRD1, FOSL2 and LILRB3, were 0.771, 0.938 and 0.972, respectively. Conclusion This study provided the screened seed genes, KLRD1, FOSL2 and LILRB3, as credible molecular biomarkers for plaques status changing in CAD progression and MI recurrence. Other seed genes, such as FOS, SOCS3 and MCL1, may also be potential targets for treatment due to their special clinical value in cardiovascular diseases.

scholarly journals Association of Waist-Hip Ratio with Angiographic Severity of Coronary Artery Disease in Patients with Acute ST- Segment Elevation Myocardial Infarction

2018 ◽  
Vol 32 (2) ◽  
pp. 70-76
Author(s):  
Mohammad Anowar Hossain ◽  
Md Abdul Kader Akanda ◽  
Mohammad Ullah ◽  
Lakshman Chandra Barai ◽  
ABM Nizam Uddin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Significant Positive Correlation ◽  
St Segment Elevation ◽  
Acute Stemi ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease ◽  
Vessel Score

Objective: Coronary artery disease (CAD) is rising in South Asia and is taking a more malignant proportion in South Asians than in Caucasians. Having a similar socioeconomic and cultural background, the scenario is same in Bangladesh. Obesity, especially abdominal is concerned as an important and modifiable risk factor for CAD which is now also raising both in developed and under developed countries. Waist-Hip ratio (WHR) is considered as an important tool for assessing abdominal obesity. The aim of this study is to evaluate the association between WHR and the severity of CAD of acute ST-segment elevation myocardial infarction (STEMI) patients so that primary prevention, early detection and proper management strategy can be taken to reduce the disease burden, morbidity and mortality.Methods: This cross sectional observational study was carried out among 105 patients with acute STEMI who received thrombolytic and underwent coronary angiography (CAG) at National Institute of Cardiovascular Diseases (NICVD), Dhaka from May, 2016 to November, 2016. They were divided into two groups, Group I (normal WHR) = 51 and group II (increased WHR) = 54, according to WHR level. Angiographic severity of coronary artery disease was assessed by vessel score and Genseni’s score.Results: Significant positive correlation was found between WHR and vessel score (r= 0.62, p=0.003). Moderate to severe CAD patients were significantly higher in increased WHR group than in normal WHR group (77.8% vs. 29.4%, p=<0.001). Significant positive correlation was also found between WHR and Genseni’s score (r= 0.71, p=0.001). Logistic regression analysis showed that a patient with increased WHR had 2.75 times higher risk of having significant CAD compared with those with the normal WHR.Conclusions: Increased WHR group had more significant coronary artery disease in terms of vessel score and Genseni’s score and can be considered as a predictor of the severity of the CAD disease in acute STEMI patients.Bangladesh Heart Journal 2017; 32(2) : 70-76

Coronary artery disease and myocardial infarction

2020 ◽  
pp. 349-354
Author(s):  
Perry Elliott ◽  
Pier D. Lambiase ◽  
Dhavendra Kumar
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Association Studies ◽  
Risk Scores ◽  
Candidate Gene Approach ◽  
Polygenic Risk ◽  
Mendelian Disorders ◽  
Genomic Studies ◽  
Artery Disease

This chapter covers coronary artery disease (CAD) and myocardial infarction, starting with an introduction to the main causal and treatable risk factors for CAD and myocardial infarction, then goes on to discuss the Mendelian disorders associated with CAD (e.g. Tangier disease, sitosterolaemia, etc.) Association studies based on the candidate gene approach are discussed along with genomic studies, e.g. polygenic risk scores.

scholarly journals High Sensitive C-Reactive Protein (hs-CRP) and Its Correlation with Angiographic Severity of Patient with Coronary Artery Disease (CAD)

1970 ◽  
Vol 19 (2) ◽  
pp. 91-97 ◽  
Author(s):  
MA Hasnat ◽  
AEMM Islam ◽  
AW Chowdhury ◽  
HILR Khan ◽  
MZ Hossain
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Extent Score ◽  
Hs Crp ◽  
Artery Disease ◽  
Vessel Score

Background: Association between the plasma hs-CRP levels and the severity of coronary stenosis in subjects remains controversial. This cross sectional study was performed in the Department of Cardiology, Dhaka Medical College during July 2008 to December 2009, to determine whether the concentrations of hs-CRP correlate with the coronary atherosclerotic disease assessed by coronary angiography. Methods: For this purpose, a total number of 90 consecutive patients having IHD admitted in the Dhaka Medical College Hospitals were enrolled in this study. Patients were divided into three groups according to their level of hs-CRP. Out of 90 cases, 22(24.4%) patients were in group I, in group II 33(36.7%) patients and rest 35(38.9%) were in group III according to their hs-CRP level. Severity of CAD was assessed by vessel score, stenosis score and extent score. Result: Significant positive correlation (r=0.7409; p<0.001 r=0.6648; p<0.001 and r=0.6386; p<0.001) was found between hs-CRP and vessel score, stenosis score and hs-CRP and extent score suggesting increasing level of hs-CRP strongly suggestive of extensive coronary artery disease. Conclusion: High level of hs-CRP strongly suggestive of extensive coronary artery disease Key words: hs-CRP; angiogram; coronary artery disease; vessel score; stenosis score and extent score. DOI: 10.3329/jdmc.v19i2.7076J Dhaka Med Coll. 2010; 19(2) : 91-97

scholarly journals Association of GRACE Risk Score with Angiographic Severity of Coronary Artery Disease in patients with ST Elevation Myocardial Infarction

2015 ◽  
Vol 8 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Tapash Saha ◽  
Md Khalequzzaman ◽  
Md Abdul Kader Akanda ◽  
Simu Saha ◽  
Asif Zaman Tushar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Risk Group ◽  
Gensini Score ◽  
Grace Risk Score ◽  
St Elevation ◽  
Artery Disease ◽  
Grace Score

Background: Clinical guidelines recommend that optimal management of acute coronary syndrome should include patient risk stratification. Predicting the anatomical extension of coronary artery disease is also potentially useful for clinical decision. The objective of our study is to determine whether the GRACE risk score correlates with the angiographic extent and severity of coronary artery disease in patients with ST elevation myocardial infarction.Methodology: 50 patients diagnosed with Acute Myocardial Infarction were included as sample by purposive sampling method. GRACE risk score for each patient was calculated and the patients were divided into groups according to the GRACE risk score: low risk (<108); intermediate risk (109-140). The severity of the coronary artery disease was assessed by vessel score and Gensini score. Relation between Grace score and Gensini score was evaluated.Results: Mean GRACE score of study population was 128.3±22.7. Mean Gensini score was 23.88±17. Mean Gensini score were 15.47±10.4, 27.75±9.26 and 31.52±16.91 in low GRACE risk group, intermediate group and high risk group respectively and the difference of mean Gensini score was statistically significant (p=0.006). In our study correlation co-efficient between GRACE risk score and Gensini score was r=0.17 (p=0.04). Multiple regression analysis showed that age more than 50 years (p=0.02), ST segment deviation (p=0.01), smoking (p=0.02), hypertension (p=0.01) were able to independently predict patients with severe CAD.Conclusion: Our study demonstrates that the GRACE risk score carries a significant positive correlation with the coronary artery disease severity in patients with STEMI.Cardiovasc. j. 2015; 8(1): 30-34

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