title: Relation of the aortic stiffness with the GRACE risk score in patients with the non ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Current guidelines recommend clinical risk scoring systems for the patients diagnosed and determinated treatment strategy with in Non-ST-elevation elevation myocardial infarction (NSTEMI). Previous studies demonstrated association between aortic elasticity properties, stiffness and severity CAD. However, the associations between Aortic stiffness, elasticity properties and clinical risk scores have not been investigated. In the present study we have evaluated the relation between the Global Registry of Acute Coronary Events (GRACE) risk score and aortic stiffness in patients with NSTEMI.
  
  
  METHODS
  We prospectively analyzed 87 consecutive patients with NSTEMI. Aortic elastic parameter and stiffness parameter were calculated from the echocardiographically derived thoracic aortic diameters (mm/m(2)), and the measurement of pulse pressure obtained by cuff sphygmomanometry. We have categorized the patients in to two groups as low ((n = 45) (GRACE risk score ≤ 140)) and high ((n = 42) (GRACE risk score > 140)) risk group according to GRACE risk score and compare the both groups.
  
  
  RESULTS
  Table 1 shows baseline characteristics of patients. Our study showed that Aortic strain was significantly low (3.5 ± 1.4, 7.9 ± 2.3 respectively, p < 0.001) and aortic stiffness index was significantly high (3.9 ± 0.38; 3 ± 0.35, respectively, p < 0.001) in the high risk group values compared to those with low risk group. The aortic stiffness index was the only independent predictor of GRACE risk score (OR: 119.390; 95% CI: 2.925-4872.8; p = 0.011) in multivariate analysis.
  
  
  CONCLUSIONS
  We found a significant correlation between aortic stiffness, impaired elasticity and GRACE risk score. Aortic stiffness index was the only independent variable of the high GRACE risk score. The inclusion of aortic stiffness into the GRACE risk score could allow improved risk classification of patients with ACS at admission and this may be important in the diagnosis, follow up and treatment of the patients.
authors.affiliation: Departmant of Cardiology, Artvin State Hospital Artvin, Turkey.
authors.forename: Gedikli
authors.initials: G
authors.lastname: Omer
authors.affiliation: Departmant of Cardiology, Gazi State Hospital Samsun, Turkey.
authors.forename: Aksan
authors.initials: A
authors.lastname: Gokhan
authors.affiliation: Departmant of Cardiology, Artvin State Hospital Artvin, Turkey.
authors.forename: Uzun
authors.initials: U
authors.lastname: Adem
authors.affiliation: Department of Cardiology, Faculty of Medicine, İstanbul Bilim University İstanbul, Turkey.
authors.forename: Demircan
authors.initials: D
authors.lastname: Sabri
authors.affiliation: Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University Samsun, Turkey.
authors.forename: Soylu
authors.initials: S
authors.lastname: Korhan
keywords: Aortic stiffness; GRACE risk score; aortic elasticity; non ST-segment elevation myocardial infarction