The GRACE risk score in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

Abstract

IntroductionAcute coronary syndrome represents a major cause of mortality throughout the world. To date, there are only a few reports of ST-segment elevation type 1 myocardial infarction in patients with COVID-19. The aim of this study was to describe the clinical and angiographic characteristics alongside the prediction of in-hospital mortality using the GRACE risk score in this group.Material and methodsThis was a single-center, retrospective study of consecutive patients admitted to a multi-specialist hospital with confirmed ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention. Demographic, clinical and angiographic characteristics were compared between survivors and non-survivors.ResultsTwenty-five patients, of whom 23 (92%) were men, with confirmed STEMI and COVID-19, with a median age of 70 years and high comorbidity burden, were included in this study. They were treated with percutaneous coronary intervention and 12 (48%) of them died. Non-survivors had elevated high-sensitivity C-reactive protein (hsCRP) (p = 0.026) and D-dimer (p = 0.042) and reduced left ventricular ejection fraction (30 ±9 vs. 41 ±7; p = 0.003). Postprocedural TIMI 3 flow grade was less frequently observed in this group (p = 0.039). There was a higher GRACE score in the non-survivor group (mean ± SD; 210 ±35 vs. 169 ±42, p = 0.014). In ROC analysis, GRACE score predicted in-hospital death with an AUC of 0.788 (95% CI: 0.6–0.98, p = 0.014). A score of 176 was identified as the optimal cut-off with a sensitivity of 92% and specificity of 69%.ConclusionsThe GRACE risk score is a good predictor of in-hospital mortality in patients presenting with STEMI with concomitant COVID-19.

Hematological Biomarkers of Troponin, Neutrophil-to-Lymphocyte Ratio, and Monocyte-toLymphocyte Ratio Serve as Effective Predictive Indicators of High-Risk Mortality in Acute

“…It was shown in this study that ACS patients are predominated by the male sex, mostly in STEMI with the percentage of 77,5% This reflects a study by Ginanjar et al which displayed 76.2% of the STEMI group are male patients with the median age of 57 years old [ 10 ]. Another similar result from Wojcik et al showing 92% of the ACS patients are male and the median age was 70 years old [ 11 ].…”

High in-hospital mortality and prevalence of cardiogenic shock in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

“…Prediction of in-hospital mortality based on the Global Registry of Acute Coronary Events (GRACE) risk score in COVID-19-positive patients has already been assessed positively by Wójcik et al [ 30 ]. This is most likely related to the more frequent occurrence of CS (13% vs. 32%; p = 0.035), i.e.…”

Adaptability of prognostic prediction models for patients with acute coronary syndrome during the COVID-19 pandemic

“… 8 9 A literature shows that the GRACE risk score has the capability to accurately predict in-hospital mortality in patients with STEMI concomitant with COVID-19. 10 Furthermore, the GRACE risk score demonstrated versatility to predict in-hospital mortality, major ischaemic events and the necessity for advanced ventilatory support and intensive care unit admission even for patients without ACS hospitalised due to COVID-19. 11 A machine learning–based prediction model, KOTOMI, has shown the prediction capability for in-hospital mortality in patients with STEMI with enhanced precision compared with conventional methods.…”