P838Is multi-biomarker combination approach comparable to the GRACE risk score for short-term mortality prediction in acute myocardial infarction cases?

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction</jats:title> <jats:p>The Global Registry of Acute Coronary Events (GRACE) score is said to be a superior predictor of mortality in acute myocardial infarction (AMI) patients, and same applies to biochemical parameters as N-terminal pro-B-type natriuretic peptide (N-BNP), Troponin-T (TnT) and high-sensitivity C- reactive protein (hs-CRP) levels.</jats:p> </jats:sec> <jats:sec> <jats:title>Purpose</jats:title> <jats:p>We validated that whether each or combination of biochemical parameters are comparable to GRACE score or not for mortality prediction in AMI patients.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>We investigated about clinical background including The GRACE score, above parameters and in-hospital mortality in 754 AMI patients (mean age 66±13y/o, 609 ST-elevated AMI cases) received emergency percutaneous coronary intervention (PCI) successfully during 8 years in a single center retrospectively. Combination of biochemical parameters are derived from N-BNP, TnT and hs-CRP by logistic regression analyses. We compared The GRACE score with each or combination of biochemical parameters between survival (SG) and non-survival group (nSG) on receiver operating characteristic (ROC) analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Result</jats:title> <jats:p>In-hospital mortality was 6.8%. The GRACE score (106±33 versus 161±32; p<0.005) and N-BNP level (2458±7058 versus 8880±11331pg/ml; p<0.005) were significantly lower in SG than nSG. Area under the ROC curve about in-hospital mortality of The GRACE score were higher (0.868) than N-BNP (0.787; p=0.007), TnT (0.613; p<0.005), hs-CRP levels (0.614; p<0.005) and multi-biomarker combination (0.742; p=0.016) as Figure 1.</jats:p> <jats:p>Area under the curve of the composite with the GRACE score and multi-biomarker is not increased compared with the GRACE score alone (0.868 versus 0.865; p=n.s.).</jats:p> <jats:p>Figure 1</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The GRACE score is a superior predictor about in-hospital mortality than each or combination of biochemical parameters in AMI patients. Multi-biomarker combination dose not refine the accuracy of the GRACE score.</jats:p> </jats:sec>