Journal of Rare Cardiovascular Diseases
ISSN: 2299-3711 (Print) | e-ISSN: 2300-5505 (Online)
Background In emergency rooms and other clinical environments, acute coronary syndrome (ACS) is among the most often encountered Patient mortality from ACS is influenced by several risky variables. Among the prognostic markers, pulse pressure—which reflects the pulsatile element of blood pressure and is defined as the difference between systolic and diastolic blood pressure—has proven to be a practical and simple accessible clinical indicator. Pulse pressure, in contrast to static measures like systolic, diastolic, or mean arterial pressures, reveals cardiac function and vascular compliance. In this investigation, the GRACE score—a well-known instrument for predicting in-hospital mortality in ACS—was contrasted with pulse pressure in classifying ACS patients. Objective This study’s main goal is to investigate how ACS patients are classified according to pulse pressure and to analyze its prognostic value relative to the GRACE score, so highlighting pulse pressure’s applicability and accessibility in medical environments. Methods Using standard diagnostic criteria of clinical symptoms, ECG results, and cardiac enzyme levels, this study comprised 100 ACS-confirmed patients at IBN-SINA Teaching Hospital in Mosul. Through surveys and clinical evaluations, data were obtained. Based on pulse pressure, patients were divided into three groups: normal, narrow, and wide. For every participant, GRACE scores were computed. Exclusion criteria included disorders including congestive heart failure, valvular heart disease, endocarditis, severe anemia, thyrotoxicosis, chronic kidney disease, pregnancy, and athletic status that might influence pulse pressure. Results Among the 74 men and 26 women in the study group, ages ranged from 30 to 89 years. Men were more often found to have abnormal pulse pressures. Among the 26 participants with narrow pulse pressure, 24 had wide pulse pressure; the rest had normal readings. With the wide pulse pressure group showing the highest creatinine levels, a very strong association (p = 0.003) between pulse pressure and serum creatinine levels was discovered. Wide pulse pressure was also strongly correlated with cardiac arrest and was linked significantly to higher systolic blood pressure measurements. STEMI was more prevalent than NSTEMI; neither wide nor narrow pulse pressure was linked with unstable angina. Patients with normal pulse pressure (p = 0.037) had more positive cardiac enzyme findings, but those with irregular pulse pressures also often showed positive results. While lower Killip classes were more frequent in the normal pulse pressure group (p = 0.008), narrow pulse pressure was linked with greater Killip class, signifying more severe heart failure. Moreover, while 72% of those with normal pulse pressure had lower GRACE scores, 50% of those with narrow pulse pressure were found to have high GRACE scores, indicating a very important link (p = 0.007). Conclusion In individuals with acute coronary syndrome, pulse pressure demonstrated great predictive value. Both narrow and broad pulse pressures were shown in this investigation to be associated with negative clinical results. Emphasizing its possible part in risk stratification of ACS patients, narrow pulse pressure was strongly linked with greater GRACE scores and more strongly correlated with in-hospital mortality.
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