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ȣ - 500014 72 |
Clinical Value of GRACE Score and B-type Natriueretic Peptide in the Prediction of Mortality in Patients with Acute Coronary Syndrome |
전남대학교병원 심장센터, 광주원광대학병원 |
신은숙, 정명호, 이영훈, 지순일, 정소영, 이옥희, 강정자, 윤소영, 유정은, 홍영준, 윤남식, 황선호, 김주한, 홍서나, 김계훈, 박형욱, 안영근, 조정관, 박종춘, 강정채, 박옥규 |
Background: This study was aimed to evaluate the validity of the Global Registry of Acute Coronary Event (GRACE) and B-type natriuretic peptide (BNP) in patients with acute coronary syndrome (ACS).
Methods: One thousand three hundreds eight patients (63.6±12.0 years, 921 male), who were admitted at coronary care unit (CCU) of Chonnam National University Hospital between January 2004 and December 2005, were analyzed. The patients were divided into two groups: the survived group (Group I: n=1,298, 871 male, 63.1±9.7 years) and the moribund group (Group II: n=80, 50 male, 67.4±8.5 years). Clinical characteristics, risk factors for atherosclerosis, echocardiographic findings, GRACE score and NT-proBNP were compared between the two groups.
Results: The overall mortality was 5.8 %, 80 out of 1,378 patients. Mortality was higher in patients with Killip IV (46.7 %, 50 out of 107 patients) than Killip Ⅱ or Ⅲ and elderly patients more than 80 years (42.7 %, 38 out of 89 patients). High Killip class and old age were associated with high mortality (p<0.0001 respectively). Total score of GRACE was elevated in group II (142±40.3 vs. 240±40.0) and high GRACE score was significant predictor of mortality (p<0.0001, r=0.827). Sensitivity, specificity, positive and negative predictability of GRACE score were 73 %, 94 %, 74 % and 93 %, respectively. The level of NT-proBNP was 2181.6±5396.0 pg/mL in group I and 9954.4±12820.0 pg/mL in group II (p<0.001). The level of NT-proBNP was correlated with mortality (p<0.001, r=0.270).
Conclusions: GRACE score and NT-proBNP level are useful predictors for the mortality of ACS.
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