The Relationship between GRACE Score and Epicardial Fat Thickness in non-STEMI Patients

Abstract

BackgroundGRACE risk score (GS) is a scoring system which has a prognostic significance in patients with non-ST segment elevation myocardial infarction (non-STEMI).ObjectiveThe present study aimed to determine whether end-systolic or end-diastolic epicardial fat thickness (EFT) is more closely associated with high-risk non-STEMI patients according to the GS.MethodsWe evaluated 207 patients who had non-STEMI beginning from October 2012 to February 2013, and 162 of them were included in the study (115 males, mean age: 66.6 ± 12.8 years). End-systolic and end-diastolic EFTs were measured with echocardiographic methods. Patients with high in-hospital GS were categorized as the H-GS group (in hospital GS > 140), while other patients were categorized as the low-to-moderate risk group (LM-GS).ResultsSystolic and diastolic blood pressures of H-GS patients were lower than those of LM-GS patients, and the average heart rate was higher in this group. End-systolic EFT and end-diastolic EFT were significantly higher in the H-GS group. The echocardiographic assessment of right and left ventricles showed significantly decreased ejection fraction in both ventricles in the H-GS group. The highest correlation was found between GS and end-diastolic EFT (r = 0.438).ConclusionEnd-systolic and end-diastolic EFTs were found to be increased in the H-GS group. However, end-diastolic EFT and GS had better correlation than end-systolic EFT and GS.

An Important Question That Needs to Be Proved: Is There Any Relationship between the Epicardial Fat Thickness and the Coronary Artery Complexity in Patients with Acute Non-ST Elevation Myocardial Infarction?

“…Additionally, positive correlation existed between EFT and BMI, HbA1C, and Tr-I measurements. Our results are in accordance with Gul et al (37) who investigated whether endsystolic and end-diastolic EFT was more closely associated with NSTEMI patients according to the Global Registry of Acute Coronary Events (GRACE) risk score (GS). They found that both endsystolic and end-diastolic EFT values were increased in high GS patients as compared to those of low-moderate GS patients.…”

Original research. The Assessment of Epicardial Adipose Tissue in Acute Coronary Syndrome Patients. A Systematic Review

“…38,[43][44][45] One study 43 found a significant association between EAT and GRACE scores (p <0.001), though this was not corroborated by other studies. 38 The angiographic SYNTAX score for coronary lesion severity and the clinical TIMI risk score for adverse coronary events were also found to be significantly linked with EAT.…”

“…[38][39][40][41][42][43][44][45] Table 1 presents a summary of the included manuscripts. All systematized manuscripts contain a concise and clear portrayal of the inclusion and exclusion criteria and the method for assessing EAT, either through cardiac CT or TTE (Table 1).…”

“…[38][39][40][41][43][44][45] Zencirci et al (2014) hypothesized that there is an inverse association between the EAT and the STsegment resolution following primary PCI for acute STE-MI. 45 Other studied risk scores are the SYNTAX score for coronary atherosclerosis severity, the GRACE and TIMI risk scores for survival following an acute cardiac event,…”

The Relation between Epicardial Fat Thickness and Prognostic Risk Scores

“…We read the article "The Relationship between GRACE Score and Epicardial Fat Thickness(EFT) in non-STEMI Patients" by Gul et al 1 The authors concluded that end-systolic and end-diastolic EFTs were found to be increased in the higher GRACE group.…”