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Vojnosanitetski pregled 2022 Volume 79, Issue 9, Pages: 868-877
https://doi.org/10.2298/VSP200204055D
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GRACE, SYNTAX I and SYNTAX II scores as predictors of one-year MACE outcome in patients with myocardial infarction treated with percutaneous coronary intervention

Davidović Aleksandar (University of Belgrade, Faculty of Dental Medicine, Belgrade, Serbia + Clinical Hospital Center Zvezdara, Department of Interventional Cardiology, Belgrade, Serbia), davidovicalex@hotmail.com
Cvijanović Dane ORCID iD icon (Clinical Hospital Center Zvezdara, Department of Interventional Cardiology, Belgrade, Serbia)
Davidović Jelica (Clinical Hospital Center Zvezdara, Department of Interventional Cardiology, Belgrade, Serbia)
Lazić Snežana ORCID iD icon (University of Priština/Kosovska Mitrovica, Faculty of Medicine, Internal Medicine Clinic, Kosovska Mitrovica, Serbia)
Lazić Bratislav (University of Priština/Kosovska Mitrovica, Faculty of Medicine, Surgical Clinic, Kosovska Mitrovica, Serbia)
Čučić Luka (Clinical Hospital Center Zvezdara, Department of Interventional Cardiology, Belgrade, Serbia)
Milić Marija (University of Priština/Kosovska Mitrovica, Faculty of Medicine, Institute of Epidemiology, Kosovska Mitrovica, Serbia)
Marković-Nikolić Nataša ORCID iD icon (Clinical Hospital Center Zvezdara, Department of Interventional Cardiology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)

Background/Aim. The fundamental objective of primary percutaneous coronary intervention (PCI) in myocardial infarction is to provide early, complete, and sustained flow in the occluded artery that has led to myocardial ischemia or necrosis. The aim of this study was to determine the predictive power of a combination of GRACE, SYNTAX I, and SYNTAX II scores in predicting major adverse cardiovascular events (MACE) and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) after primary PCI. Methods. The study included 400 patients who had their first acute myocardial infarction and underwent PCI. The patients were treated and followed for one year at the Clinical Hospital Center Zvezdara at the Department of Interventional Cardiology. By monitoring the defined clinical parameters, a comparative analysis of risk scores GRACE, SYNTAX I, and SYNTAX II was performed. Their sensitivity, specificity as well as predictive possibilities in predicting adverse outcomes were determined. Results. The incidence of MACE in our sample was 12.8%. Patients with STEMI entity had significantly higher values of GRACE, SYNTAX I, and SYNTAX II scores. The highest value for predicting the occurrence of MACE was shown by the SYNTAX II score (score value 29.3), with a sensitivity of 88.2% and a specificity of 76.8%. The GRACE score was a significant predictor of SYNTAX I and SYNTAX II scores. A two-way correlation was observed between the high score values of all three scores. Conclusion. The presented scores for the assessment of clinical and angiographic indicators showed good predictive power in assessing the outcome of adverse cardiovascular events in both clinical entities of acute myocardial infarction during one-year follow-up. By using the proposed scores to assess MACE, we can single out high-risk patients in order to prevent adverse events and reduce mortality. This suggests its suitability for clinical use in this patient population.

Keywords: myocardial infarction, percutaneous coronary intervention, prognosis, risk assessmen, treatment outcome

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