Giá trị của thang điểm angiographic grace trong tiên lượng tử vong nội viện ở bệnh nhân nhồi máu cơ tim cấp ST chênh lên được can thiệp mạch vành qua da

Abstract

A combined prospective and retrospective cohort study was conducted on 157 patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI) at Tam Duc Hospital from February 2020 to February 2025; the purpose of the study was to evaluate the prognostic value of the angiographic GRACE score for in-hospital mortality. The mean age was 58.6 ± 11.1 years old, with 81.5% male patients. The in-hospital mortality rate was 7.6%. The angiographic GRACE score was significantly higher in deceased patients compared with survivors (232.9 ± 49.4 vs. 159.9 ± 30.9; p < 0.001). Receiver operating characteristic (ROC) analysis demonstrated excellent predictive performance for in-hospital mortality, with an AUC of 0.909 (95% CI: 0.831–0.986; p < 0.001). At a cutoff value of > 193, the score achieved a sensitivity of 91.7%, specificity of 84.8%. In univariate logistic regression analysis, the angiographic GRACE score was significantly associated with in-hospital mortality (OR = 1.68 per 10-point increase; 95% CI: 1.31 – 2.14; p < 0.001), with good model calibration (Hosmer–Lemeshow p = 0.693). These findings suggest that the angiographic GRACE score may be useful for in-hospital risk stratification in STEMI patients undergoing PCI; however, the results should be interpreted with caution due to the limited number of mortality events and warrant confirmation in larger studies.