Hematologic Indices and Global Registry of Acute Coronary Events (GRACE) Risk Score in Acute Coronary Syndrome Patients in Ethiopia

Abstract

BACKGROUND: Prognostic ratings are essential for making quick clinical decisions. In patients with acute coronary syndrome (ACS), the Global Registry of Acute Coronary Events (GRACE) score is often used to predict in-hospital mortality. Hematological indices are strongly correlated with the likelihood of adverse outcomes in ACS patients, given the systemic hypoxemia and inflammation linked to its pathophysiology. This study aimed to assess the relationship between hematologic indices and the GRACE risk score in ACS patients.

METHODS: We consecutively recruited patients diagnosed with ACS at Jimma Medical Center (JMC) from May 1, 2022, to October 31, 2023. We performed biochemical analyses and complete blood counts, calculating GRACE scores. We correlated two continuous parameters and evaluated GRACE risk score independent predictors using multivariate linear regression analysis.

RESULTS: A total of 110 patients were included, with 74 (67.3%) being men. The mean age was 56 (±11) years. Significant correlations were found between red cell distribution width (RDW), mean platelet volume (MPV), plateletcrit, and platelet count with worse GRACE risk scores (r = 0.569, P < 0.001; r = 0.585, P < 0.001; r = 0.400, P < 0.001; r = 0.274, P < 0.013, respectively). In multivariable linear regression, higher RDW and MPV were associated with higher GRACE risk scores.

CONCLUSION: This study revealed significant differences in hematologic parameters among ACS patients with varying GRACE risk scores. Increased RDW and MPV were identified as independent predictors for high GRACE risk scores.