Study of GRACE and TIMI Risk Scores’ Application in the Risk Stratification in Patients with Acute Coronary Syndrome in Qinghai

Objective: To compare the risk stratification ability and prognostic evaluation values of GRACE and TIMI risk scores in patients with Acute Coronary Syndrome (ACS) in Qinghai. Methods: The clinical data of 385 patients with ACS treated at our hospital from January 2021 to October 2022 were analyzed to calculate the Grace and TIMI risk scores of each patient. The main adverse cardiovascular events (MACE) within 30 days of onset and 1 year after discharge were followed up. The receiver operating characteristic (ROC) curves of the two scoring systems were plotted, and the area under the curve (AUC) was compared. Results: There was no statistically significant difference between the risk stratification in patients with ACS according to GRACE and TIMI scores (χ2=0.316, P=0.854). The scores of both grading systems showed a tendency to increase with increasing risk stratification (P<0.001). In addition, the higher the GRACE and TIMI risk scores, the higher the incidence rate of MACE in patients within 30 days of the onset and 1 year after discharge (P<0.01). Taking 143 points of the GRACE risk score as the cut-off value, the sensitivity and specificity of predicting MACE within 1 year after discharge were 89.93% and 90.83%, respectively. The AUC value under the ROC curve was 0.775. However, if 3.8 points of TIMI risk score was taken as the cut-off value, the sensitivity and specificity of predicting MACE within 1 year after discharge were changed to 81.15% and 89.27%, respectively, while the AUC value was 0.743. The difference between the AUC values calculated using the two risk scores was statistically significant. (Z=5.436, P<0.01). Conclusion: GRACE and TIMI risk scores can be used for risk stratification of patients with ACS in Qinghai. The GRACE risk score had a higher predictive value for recent adverse cardiovascular events in patients with ACS.