GRACE score predicts systemic inflammation in patients with acute coronary syndrome

Abstract Background New insights of inflammation CANTOS (1) and COLCOT (2) demonstrated the importance of blocking inflammation in CAD for major outcomes, but only in patients with systemic inflammation. The GRACE score is a readily available tool that uses a variety of items none related to inflammation per se. Many studies have emphasised the importance of inflammation, however, most markers are not readily available in the clinic setting. Purpose Determine if GRACE score may reflect systemic inflammation measured by WBC, hsCRP, albumin, IL-1β, IL-6, IL-8, and IL-10. Methods 77 patients with NSTEMI/STEMI were enrolled at time of hospital admission, all patients had 18 years old and received no therapy before the samples were obtained. Patients with pregnancy or in postpartum period, infectious, autoimmune, hepatic, or neoplastic diseases were excluded; as well as patients with current or previous dialysis, transplant, episodes of acute or chronic heart failure, and previous ACS. WBC, hsCRP and troponin I, IL-1β, IL-6, IL-8, IL-10, were measured. Low rank regression splines, a predefined analysis of IL-1β + hsCRP/ IL-1β + IL-6 / IL-6 + hsCRP vs GRACE score was performed, adjusted by sex, type of ACS, hypertension, and diabetes. A p