Combined application of GRACE and CRUSADE in prognostic evaluation of PCI-treated patients with non-ST-elevation acute coronary syndromes

AIM To evaluate the combined use of GRACE and CRUSADE risk stratification schemes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) after percutaneous coronary intervention (PCI) and each of the scores individually in terms of prognostic prediction. METHODSA total of 320 NSTE-ACS patients treated with PCI were followed for at least 1.5 years. The cohort (according to the GRACE and CRUSADE risk scores) was divided into three groups: lowest risk group (GRACE<141; CRUSADE<41), intermediate risk group (GRACE<141, CRUSADE≥41; GRACE≥41, CRUSADE<41) and highest risk group (GRACE≥141; CRUSADE≥41). Descriptive statistics and multivariate survival analyses were used to compare major cardiovascular events, mortality and bleeding events between groups. RESULTSSurvival analysis differentiated three risk strata. The three risk scores presented a good fit for mortality and bleeding events. Using logistic analysis and ROC curve, combined risk scores showed excellent discriminatory capacity for mortality and bleeding risk and with no statistically significant difference among the three risk scores. CONCLUSIONCombined risk scores are good for prediction of all-cause mortality and bleeding. Combined assessment is a practical and better approach to risk stratification and prognostic prediction in NSTE-ACS patients after PCI.