The GRACE (Global Registry of Acute Coronary Events) risk score has been proposed in predicting short-term death in patients who are diagnosed with acute coronary syndrome. In this study, we investigated the significance of the GRACE score for acute kidney injury (AKI) in cardiogenic shock (CS)-ST elevation myocardial infarction (STEMI) patients who were treated with primary percutaneous coronary intervention (PPCI).
We retrospectively examined a total of 492 consecutive CS-STEMI patients who had undergone PPCI. The GRACE score was calculated for each patient. Patients were stratified by tertiles (T1, T2, and T3) according to the GRACE score and the incidence of AKI was compared between the groups.
In univariate analysis, the incidence of AKI was significantly higher for patients allocated into the T3 group, as compared to patients in the T1 group (Odds ratio (OR): 2.8, 95% confidence interval (CI): 1.84.1, p<0.001). Following including all confounding variables, participants in the T3 group had a 3.1-fold higher incidence of AKI (OR: 3.1, 95% CI: 1.95.4, p<0.001). In a receiver operating curve analysis, the GRACEs score of the area under curve value for AKI was 0.70 (p<0.001, 95% CI: 0.65-0.74) with 69.2% sensitivity and 68.8% specificity.
The GRACE score provide an independent prognostic marker of AKI in CS patients related with STEMI. Based on our data, we propose that the GRACE score is a simple and clinically applicable directive tool for rapid risk stratification of AKI in STEMI patients complicated with CS.