PROGNOSTIC VALUE OF GRACE VERSUS TIMI SCORE FOR IN-HOSPITAL OUTCOMES AFTER NON-ST-ELEVATION ACUTE CORONARY SYNDROME

Objectives: To compare the predictive value of TIMI and GRACE score for predicting in-hospital outcomes after non-ST elevation acute coronary syndrome (NSTE-ACS). Methodology: This study included prospectively recruited cohort of patients presented to a tertiary care cardiac center of Karachi, Pakistan who were diagnosed with NSTE-ACS. GRACE and TIMI score were obtained and in-hospital mortality was recorded. The receiver operating characteristic (ROC) curves analysis was performed and area under the curve (AUC) was obtained as indicative of predictive value for both scores. Results: A total of 300 patients were included, out of which 76.7%(230) were male and mean age was 58.04±10.71 years. Risk profile comprises of 84.3%(253) hypertensive, 42.0%(126) diabetic, 27.3%(82) smokers, 9.0%(27) obese, 15.3%(46) dyslipidemic, and 31%(93) with sedentary lifestyle. Mean GRACE and TIMI score were 120.19±33.17 and 3.18±0.85 respectively. In-hospital mortality rate was 5.3%(16). AUC for the GRACE score was 0.851 [0.767 - 0.934] with the optimal cut-off value of 150 with sensitivity of 68.8% and specificity of 84.9%. The AUC for the TIMI score was 0.781[0.671 - 0.891] with the optimal cut-off value of 4 with sensitivity of 75.0% and specificity of 67.6%. Conclusion: The GRACE score has high discriminating strength for predicting in-hospital mortality after NSTE-ACS. GRACE score should be used as risk stratification modality in clinical decision making for the management of NSTE-ACS.

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Prognostic value of GRACE score for in-hospital and 6 months outcomes after non-ST elevation acute coronary syndrome

The Egyptian Heart Journal ◽

10.1186/s43044-021-00146-9 ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Dileep Kumar ◽

Arti Ashok ◽

Tahir Saghir ◽

Naveedullah Khan ◽

Bashir Ahmed Solangi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Acute Coronary Syndrome ◽

Family History ◽

Hospital Mortality ◽

Hospital Stay ◽

Predictive Value ◽

Coronary Syndrome ◽

St Elevation ◽

Elevation Acute Coronary Syndrome ◽

Grace Score

Abstract Background The aim of this study was to determine the predictive value of the Global Registry of Acute Coronary Events (GRACE) score for predicting in-hospital and 6 months mortality after non-ST elevation acute coronary syndrome (NSTE-ACS). Results In this observational study, 300 patients with NSTE-ACS of age more than 30 years were included; 16 patients died during the hospital stay (5.3%). Of 284 patients at 6 months assessment, 10 patients died (3.5%), 240 survived (84.5%), and 34 were lost to follow-up (12%) respectively. In high risk category, 10.5% of the patients died within hospital stay and 11.8% died within 6 months (p = 0.001 and p = 0.013). In univariate analysis, gender, diabetes mellitus, family history, smoking, and GRACE score were significantly associated with in-hospital mortality whereas age, obesity, dyslipidemia, and GRACE were significantly associated with 6 months mortality. After adjustment, diabetes mellitus, family history, and GRACE score remained significantly associated with in-hospital mortality (p ≤ 0.05) and age remained significantly associated with 6 months mortality. Conclusion GRACE risk score has good predictive value for the prediction of in-hospital mortality and 6 months mortality among patients with NSTE-ACS.

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