The relationship between uric acid/albumin ratio, nutritional status, and GRACE risk score in individuals with acute coronary syndrome

Background and Aim: The primary aim of this study is to investigate the relationship between uric acid/albumin ratio, nutritional status, and GRACE (Global Registry of Acute Coronary Events) risk score in adult individuals diagnosed with acute coronary syndrome (ACS). Materials and Methods: In this study, a 26-item participant information form including the sociodemographic characteristics, dietary habits, physical activity status, anthropometric measurements, and blood biochemical parameters of 128 patients diagnosed with acute coronary syndrome was recorded by the researcher. The Food Frequency Questionnaire was also completed by the researcher. In addition, the Nutritional Risk Screening-2002 (NRS-2002), Subjective Global Assessment (SGA), Multidimensional Quality of Life Scale (MQOLS), and Visual Analog Scale (VAS) were administered to the participants by the researcher. Results: Of the individuals included in this study, 71.9% were male and 28.1% were female, with a mean age of 66.89 ± 13.36 years. According to the Nutritional Risk Screening (NRS) score, being aged 65 or older (p=0.014), having a middle school or lower education level (p=0.000), not consuming alcohol (p=0.039), and not engaging in regular physical activity (p=0.001) were significantly associated with higher nutritional risk (p<0.05). A significant association was found between Subjective Global Assessment (SGA) classification and gender (p=0.029), income level (p=0.019), medication use (p=0.042), and exercise status (p=0.041). The total score of the McGill Quality of Life Questionnaire (MQOL) was significantly higher among participants with a high school education or above (p=0.005), sufficient income (p=0.000), no regular medication use (p=0.007), regular physical activity (p=0.000), and normal nutritional status based on NRS (p=0.000). Chest pain severity, measured by the Visual Analog Scale (VAS), was significantly lower in those who exercised (p=0.013) and those with normal nutritional status (p=0.000). Underweight individuals, based on body mass index, reported significantly higher pain levels compared to those with normal weight, overweight, or obesity (p = 0.012). VAS scores also varied significantly with SGA classification, with the highest scores observed in individuals with severe malnutrition (p=0.000). According to the GRACE risk score, 57.1% of underweight individuals, 20.8% of obese individuals, and 42.1% of those with severe malnutrition were identified as being at high risk of mortality (p<0.05). In a model adjusted for age and gender, there was a significant negative association between NRS score and MQOL total score (p=0.019), and a positive association between SGA classification and MQOL total score (p=0.000). Conclusion: In conclusion, the findings indicate that pharmacological approaches alone are not sufficient in the treatment processes of individuals with acute coronary syndrome. Nutritional status should also be systematically assessed and supported with appropriate nutritional interventions. In order to better elucidate the relationship between nutrition and disease progression, future studies with larger sample sizes and long-term follow-up are needed. Keywords: Acute coronary syndrome, grace risk score, malnutrition, uric acid/albumin ratio.