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The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study

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ชื่อเรื่อง : The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study
นักวิจัย : Chotechuang Y. , Phrommintikul A. , Muenpa R. , Patumanond J. , Chaichuen T. , Kuanprasert S. , Thanachikun N. , Benjanuwatra T. , Sukonthasarn A.
คำค้น : -
หน่วยงาน : มหาวิทยาลัยเชียงใหม่
ผู้ร่วมงาน : -
ปีพิมพ์ : 2559
อ้างอิง : 2-s2.0-84994406623 , 10.1186/s12872-016-0383-3 , https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84994406623&origin=inward , http://cmuir.cmu.ac.th/jspui/handle/6653943832/41350
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ความเชี่ยวชาญ : -
ความสัมพันธ์ : -
ขอบเขตของเนื้อหา : -
บทคัดย่อ/คำอธิบาย :

© 2016 The Author(s). Background: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital. Methods: We retrospectively analysed the data from the Maharaj Nakorn Chiang Mai Hospital acute ST-elevation myocardial infarction (STEMI) registry during the period 2007-2012. The STEMI patients who had successfully fibrionolysis in non PCI-capable hospital and received delayed PCI (during 24 h to 14 days after successful fibrinolytic therapy) at Maharaj Nakorn Chiang Mai hospital were included. The primary end point for this analysis was the composite outcomes, which included all-cause mortality, re-hospitalization with acute coronary syndrome (ACS), re-hospitalization with heart failure (HF) and stroke at 1 and 6-month. Results: A total of 152 patients were included. 88 patients and 64 patients were in low GRACE group (GRACE risk score ≤ 125) and intermediate to high GRACE group (GRACE risk score above 126), respectively. The median time from fibrinolysis to coronary intervention in low GRACE group was 8.5 days (interquartile range, 4.6-10.9) and 7.9 days (interquartile range,3.2,12.0) in intermediate to high GRACE group (p = 0.482). At 1 month, the composite cardiovascular outcome at 1 month occurred in 2 patients (2.3 %) in low GRACE group and 10 patients (15.6 %) in intermediate to high GRACE group (P = 0.003). During 6 months, the composite cardiovascular outcomes occurred in 6 patients (6.8 %) in low GRACE group and 12 patients (18.7 %) in intermediate to high GRACE group (P = 0.024). The cumulative of composite cardiovascular outcome was significant higher in intermediate to high GRACE group than in low GRACE group (Hazard ratio: 2.97, 95 % CI 1.11-7.90; p = 0.030). Conclusion: The long delay pharmacoinvasive strategy in intermediate to high GRACE score after successful fibrinolysis in non PCI-capable facilities were associated with worse cardiovascular outcomes than the patients with low GRACE score at 1 and 6 months. GRACE risk score may be helpful and guided the clinicians in non PCI-capable center in early transferred to early intervention in STEMI patients after fibrinolytic therapy.

บรรณานุกรม :
Chotechuang Y. , Phrommintikul A. , Muenpa R. , Patumanond J. , Chaichuen T. , Kuanprasert S. , Thanachikun N. , Benjanuwatra T. , Sukonthasarn A. . (2559). The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study.
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Chotechuang Y. , Phrommintikul A. , Muenpa R. , Patumanond J. , Chaichuen T. , Kuanprasert S. , Thanachikun N. , Benjanuwatra T. , Sukonthasarn A. . 2559. "The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study".
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ .
Chotechuang Y. , Phrommintikul A. , Muenpa R. , Patumanond J. , Chaichuen T. , Kuanprasert S. , Thanachikun N. , Benjanuwatra T. , Sukonthasarn A. . "The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study."
    เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ , 2559. Print.
Chotechuang Y. , Phrommintikul A. , Muenpa R. , Patumanond J. , Chaichuen T. , Kuanprasert S. , Thanachikun N. , Benjanuwatra T. , Sukonthasarn A. . The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: A retrospective cohort study. เชียงใหม่ : มหาวิทยาลัยเชียงใหม่ ; 2559.