Comparison of GRACE and TIMI risk scores in the prediction ...

A recent study on NSTEMI reported that the GRACE score predicted 28-day mortality better than the TIMI score (AUC: 0.87 vs. 0.54) [24]. Another ... Skiptomaincontent Advertisement SearchallBMCarticles Search DownloadPDF Research OpenAccess Published:07January2022 ComparisonofGRACEandTIMIriskscoresinthepredictionofin-hospitalandlong-termoutcomesamongEastAsiannon-ST-elevationmyocardialinfarctionpatients LuYanqiao1,2 na1,LanShen1,2 na1,MiaoYutong1,ShenLinghong1&HeBen1,2  BMCCardiovascularDisorders volume 22,Article number: 4(2022) Citethisarticle 711Accesses Metricsdetails AbstractBackgroundRiskstratificationinnon-STsegmentelevationmyocardialinfarction(NSTEMI)determinestheinterventiontime.Limitedstudycomparedtworiskscores,theThrombolysisinMyocardialInfarction(TIMI)andGlobalRegistryofAcuteCoronaryEvents(GRACE)riskscoresinthecurrentEastAsianNSTEMIpatients.MethodsThisretrospectiveobservationalstudyconsecutivelycollectedpatientsinalargeacademichospitalbetween01/01and11/01/2017andfollowedfor4 years.PatientswerescoredbyTIMIandGRACEscoresonhospitaladmission.In-hospitalendpointsweredefinedasthein-hospitalcompositeevent,includingmortality,re-infarction,heartfailure,stroke,cardiacshock,orresuscitation.Long-termoutcomeswereall-causemortalityandcardiacmortalityin4-yearfollow-up.ResultsAtotalof232patientswereincluded(female29.7%,medianage67 years),withamedianfollow-upof3.7 years.GRACEscoregroupedmostpatients(45.7%)intohighrisk,whileTIMIgroupedthemajority(61.2%)intomediumrisk.FurthersubgroupingtheTIMImediumgroupshowedthathalf(53.5%)oftheTIMImediumriskpopulationwasGRACEhighrisk(≥ 140).ComparedtoTIMImediumgroup + GRACE  50%,aspirinusedinthepast7 days,severeangina(≥ 2episodesw/in24 h),severeangina(≥ 2episodesw/in24 h)andpositivecardiacmarker.Patientsachieved1pointforyesand0pointsforno.Patientswith0–2scoreswerelow-riskgroupswhile3–4scoresweremedium-riskgroupsand5–7scoreswerehigh-risk.GRACEscorewascalculatedonadmissionbasedonthefollowingvariables:age,heartrate(HR),systolicbloodpressure(SBP),initialserumcreatine(Cr),Killipclassification,cardiacarrestatpresentation,initialcardiacenzymepositive,andST-segmentdeviation.Patientswhoscored ≤ 108pointswerelow-risk,109–139pointsweremedium-risk, ≥ 140pointswerehigh-risk.Wealsousedonlineriskcalculatorsfollowingtherecommendationby2020ESCguideline,https://www.outcomes-umassmed.org/risk_models_grace_orig.aspx[14].Toexploretheoptimalriskscoreinourstudypopulation,weexamineawaytoreservethetworiskscores’convenienceandpredictiveaccuracy.Wetestedthemethodtousethecombinedscore,whichfurtherstratifiedTIMImedium-riskpatientsintotheGRACE ≥ 140subgroupandGRACE