Integrating GRACE Score and red blood cell distribution width for improved major adverse cardiac events prediction in acute coronary syndrome: a cohort study

Abstract

BACKGROUND: The combined value of red blood cell distribution width (RDW) and the Global Registry of Acute Coronary Events (GRACE) risk score for evaluating major adverse cardiovascular events (MACE) in non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) patients has not been thoroughly investigated. This study aims to determine the combined value of RDW and GRACE risk scores in predicting medium-term MACE in STEMI and NSTEMI patients.METHODS: This retrospective cohort study enrolled 386 patients diagnosed with NSTEMI and STEMI. The primary outcome encompassed all-cause mortality, heart failure, recurrent myocardial infarction, coronary revascularization, and strokes. Receiver operating characteristic and Cox regression analyses were employed to assess the relationship between clinical outcomes and parameters.RESULTS: Of the patients analyzed, 76 individuals (19.4%) experienced MACE. Those who experienced MACE had notably higher GRACE scores and RDW levels compared to those who did not. Both GRACE scores and RDW were identified as independent predictors of MACE. The study identified optimal thresholds for predicting MACE as 123.5 for GRACE scores and 12.95% for RDW, with both parameters showing good predictive ability (AUC = 0.709 for GRACE scores and AUC = 0.726 for RDW). Combining RDW and GRACE scores improved the prediction of MACE events.CONCLUSIONS: The RDW level and GRACE score have demonstrated promising potential as simple yet robust predictors of MACE in patients with NSTEMI and STEMI. These metrics hold significance in risk assessment and can serve as valuable indicators of medium-term clinical prognosis.

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