Hubungan GRACE Score dengan Kejadian In-Hospital MACE pada Pasien STEMI yang Menjalani Primary PCI

Abstract: ST-Elevation Myocardial Infarction (STEMI) carries a high mortality rate, and although primary PCI is the main reperfusion therapy, the risk of in-hospital Major Adverse Cardiac Events (MACE) remains. Global Registry of Acute Coronary Events (GRACE) score is a validated risk stratification tool, however local data remains limited. This study aimed to analyze the association between GRACE score and in-hospital MACE among STEMI patients undergoing primary PCI at Prof. Dr. R. D. Kandou General hospital Manado. This analytic correlational retrospective cohort study utilized 361 medical records from January 2022-Desember 2024. GRACE score was categorized as low (≤108), intermediate (109-140), and high (>140). In-hospital MACE included heart failure, stroke, death, and reinfarction/revascularization. The results showed that16.8% of patients experienced in-hospital MACE, with heart failure and death being the most frequent events. A significant association was found between GRACE score and in-hospital MACE (p<0.001). Patients in the intermediate category were 4.46 times and those in the high category were 15.93 times more likely to experience in-hospital MACE compared to the low category. In conclusion, GRACE score is significantly associated with in-hospital MACE in STEMI patients undergoing primary PCI, with increasing risk as the GRACE score increases. Keywords: GRACE score; in-hospital MACE; primary PCI; STEMI Abstrak: ST-Elevation Myocardial Infarction (STEMI) memiliki mortalitas tinggi, dan meskipun primary PCI merupakan terapi reperfusi utama, risiko in-hospital Major Adverse Cardiac Events (MACE) tetap terjadi. Global Registry of Acute Coronary Events (GRACE) score merupakan instrumen stratifikasi risiko yang valid, namun data lokal masih terbatas. Penelitian ini bertujuan untuk menganalisis hubungan antara GRACE score dengan kejadian in-hospital MACE pada pasien STEMI yang menjalani primary PCI di RSUP Prof. Dr. R. D. Kandou Manado. Desain penelitian berupa analitik korelasi kohort retrospektif menggunakan 361 data rekam medis periode Januari 2022–Desember 2024. GRACE score dikategorikan sebagai rendah (≤108), sedang (109–140), dan tinggi (>140). Kejadian in-hospital MACE meliputi gagal jantung, stroke, kematian, dan reinfark/ revaskularisasi. Hasil penelitian mendapatkan 16,8% mengalami kejadian in-hospital MACE dengan gagal jantung dan kematian sebagai kejadian yang paling sering ditemukan. Terdapat hubungan bermakna antara GRACE score dan kejadian in-hospital MACE (p<0,001) dengan peluang 4,46 kali mengalami MACE pada kategori sedang dan 15,93 kali pada kategori tinggi dibandingkan kategori rendah. Diabetes melitus dan merokok memperkuat hubungan tersebut. Simpulan penelitian ini ialah terdapat hubungan bermakna antara GRACE score dan kejadian in-hospital MACE pada pasien STEMI yang menjalani primary PCI, dengan risiko meningkat seiring meningkatnya GRACE score. Kata kunci: GRACE score; in-hospital MACE; primary PCI; STEMI