Incorporating the erythrocyte sedimentation rate for enhanced accuracy of the global registry of acute coronary event score in patients with ST-segment elevated myocardial infarction

Abstract

There is scarce evidence that the erythrocyte sedimentation rate (ESR) could efficiently improve the prediction accuracy of the Global Registry of Acute Coronary Events (GRACE) risk score in cases of ST-elevation myocardial infarction (STEMI). A cohort of 1094 STEMI patients undergoing primary percutaneous coronary intervention was retrospectively recruited. Patients were categorized based on the ESR values. Final endpoints included cardiovascular death and major adverse cardiovascular event (MACE) occurrence. The predictive value of combined models with the GRACE score and ESR was assessed by receiver operating characteristic (ROC) analysis, net reclassification improvement (NRI), and integrated discrimination improvement. During the mean follow-up of 23 months, 34 patients died and 190 experienced MACEs, of which 23 patients died in the first year; both endpoints were more frequent in the higher group. The ESR and high-sensitivity C-reactive protein (hs-CRP) were independent risk factors of 1-year cardiovascular death, together with the GRACE score (ESR: hazard ratio = 1.03, P = .006 hs-CRP: hazard ratio = 1.00, P = .001; GRACE: 1.03, P = .012). Although no statistical improvement in the area under the ROC curve was observed in either the GRACE/ESR or the GRACE/hs-CRP model (GRACE/ESR models: 0. 8073 vs GRACE: 0.7714, P = .22; GRACE/ESR models: 0. 7815 vs GRACE: 0.7714, P = .61), the GRACE score and ESR together significantly improved the NRI (0.633; P < .001) compared with the GRACE alone. Regarding the mid-term mortality, adding the ESR to the GRACE score not only improved the NRI (0.8433; P < .001), but also increased the integrated discrimination improvement (0.0509; P = .04). The ESR is an independent risk factor of cardiovascular death and MACE in STEMI patients receiving primary percutaneous coronary intervention. The ESR comparatively enhanced the predictive values of the prognostic model, including the GRACE risk score.

A gender specific risk assessment of coronary heart disease based on physical examination data

“…The risk of CHD increases with age. Although men and women share similar risk factors, gender differences influence the pathophysiology of these indicators, for example, women often show atypical symptoms, leading to missed diagnoses of CHD 7 , 8 . In addition, dentition is closely related to the occurrence of CHD 9 .…”

“…Risk assessment tools for diseases have been established by quantifying the risk factors associated with the disease 2 – 5 . Internationally renowned coronary risk assessment tools include: Framingham Risk Score (FRS) 6 , Global Registry of Acute Coronary Event (GRACE) 7 , Systematic Coronary Risk Estimation (SCORE) and China-PAR 10-year risk prediction model 3 , 8 . These risk assessment tools played an indispensable role in the prevention of CHD.…”

Application Analysis of Positive-Pressure Connector in Invasive Blood Pressure Monitoring in Coronary Interventional Therapy

“…In case of abnormal arterial wave, it was checked whether there was thrombosis in the pressure measuring tube or catheter bending, etc. In case of thrombosis, the thrombus should be pumped back and rinsed in time to avoid intra-arterial embolism ( 7 – 10 ) ( Table 2 ).…”

The Potential of Thyroid Hormone Therapy in Severe COVID-19: Rationale and Preliminary Evidence

“…The erythrocyte sedimentation rate (ESR), an indirect index of erythrocyte aggregation, is elevated in sepsis. In acute myocardial infarction, patients with a high ESR have a greater risk for cardiovascular death and major adverse cardiovascular events (MACEs) [24]. Erythrocyte aggregation may also occur in COVID-19 [25].…”