The relationship between Gensini score and rates of 30-day mortality in acute coronary syndrome patients in China

Few studies validated the association between Gensini scores and mortality among acute coronary syndrome (ACS) patients. Therefore, we intend to evaluate the association between the severity of CAD assessed by the Gensini score and the 30-day all-cause mortality in Chinese patients with ACS. This study evaluated 2,742 patients diagnosed with ACS who underwent hospitalization and coronary angiography between August 2014 and November 2019 from 2 centers in China. The severity of coronary artery disease (CAD) was categorized into tertiles based on Gensini scores for each lesion: T1 (< 42), T2 (42 ≤ score < 76), and T3 (score ≥ 76). The correlation between Gensini scores and 30-day mortality was assessed using Cox regression analyses and Kaplan-Meier curves. During the 30-day follow-up period, 2.7% of the patients included in the study occurred mortality. Significant differences were observed in tertile Gensini scores when comparing patients who died (T1: 0.8%; T2: 2.0%; T3: 5.2%, P < 0.001). When treating Gensini scores as a continuous variable and adjusting for potential confounding factors, a positive correlation was found between Gensini scores and all-cause mortality (HR 1.012, 95% CI 1.006–1.017). Compared to individuals in the T1 group, those in higher Gensini tertiles exhibited significant increases in all-cause mortality (T2: HR 1.715, 95% CI: 0.704–4.181; T3: HR 2.376, 95% CI: 1.004–5.623; P for trend = 0.039). Subgroup analyses further demonstrated the significant association between higher Gensini scores and increased all-cause mortality was consistently observed across nearly all subgroups. The present study demonstrated that higher Gensini scores were positively associated with 30-day all-cause mortality among patients with ACS, underscoring their utility as a simple and practical tool for early risk stratification. Further research is warranted to validate these findings and to explore interventions guided by Gensini scores to improve outcomes in this population.