Prognosticators of NSTEMI Outcome Prediction Additive to GRACE Score

Introduction: The GRACE score is most commonly used to stratify the risk of major cardiovascular events, including non-ST segment elevation myocardial infarction (NSTEMI). Predictions, based on GRACE score, are often inconsistent and not suitable for all patient populations. Our objective is to examine whether GRACE score, BNP and left ventricle ejection fraction (LVEF) can predict re-hospitalization in patients with NSTEMI.

Methods: A retrospective study involving 97 adult patients who were admitted to the cardiac intensive care unit (CICU) with NSTEMI, from April 2016 to April 2018. All patients underwent a therapeutic Percutaneous Intervention (PCI). Clinical outcomes and blood biomarkers were assessed up to to PCI and a 6-month hospitalization was recorded. Cox regression was performed to examine the association of GRACE score, BNP and LVEF with hazard of a 6-month hospitalization.

Results: In patients with NSTEMI who underwent interventional PCI, BNP levels were positively associated with a 6-month hospitalization [hazard ratio Exp(B)] 1.001 (95% CI, 1.00–1.001) and for hospitalization (p<0.038). LVEF values were negatively associated with a 6-month hospitalization [hazard ratio Exp(B)] 0.950 (95% CI, 0.902–1.001) for hospitalization (p<0.053). GRACE score did not predict a 6-month hospitalization in patients with NSTEMI.

Conclusion: Predicting the risk of a 6-month hospitalization is important for the management of NSTEMI patients. We found that BNP levels and LVEF values predicted hospitalization, whereas GRACE scores did not. Further, larger studies are required to assess whether BNP and LVEF may be used for stratifying the hospitalization risk for NSTEMI patients.