Key result
GRACE score outperforms TIMI score for predicting in-hospital STEMI mortality by ~0.08 AUC.
Why the study?
GRACE and TIMI scores have varying accuracy depending on regional risk profiles, and their comparative accuracy in predicting in-hospital mortality among STEMI patients was evaluated.
Does the GRACE score have better accuracy than the TIMI score in predicting in-hospital mortality in STEMI patients?
Cohort (n=255)
No
Does the GRACE score have better accuracy than the TIMI score in predicting in-hospital mortality in STEMI patients?
Answers are grounded in this paper and cite their sources.
The GRACE score is significantly more accurate than the TIMI score for predicting in-hospital mortality in STEMI patients, likely due to its inclusion of more detailed clinical variables.
BACKGROUND: In-hospital mortality of ST-elevation myocardial infarction (STEMI) patients varies between 1% and 19% in Asia. Global Registry of Acute Coronary Events (GRACE) score and Thrombolysis in Myocardial Infarction (TIMI) score are the most frequently used risk scores for predicting in-hospital mortality. These two scores have different accuracy depending on the risk profiles of each region. This study aimed to identify the difference in accuracy between GRACE and TIMI scores. METHODS: This was an observational cohort retrospective study on consecutive patients with STEMI admitted to Dr. Hasan Sadikin General Hospital Bandung between July 2018 and June 2019. RESULTS: The risk scores were evaluated in 255 patients with STEMI, whose data were collected from medical records. Patients in this study were 58 ± 11 years old, more often male (78.8%) and have smoking (65.5%), dyslipidemia (61%), hypertension (56.5%) and diabetes mellitus (21.6 %) as their risk factors. Forty-five patients died in hospitalization (17%). The TIMI and GRACE scores revealed a significant graded increase in mortality with a rising score. There was a statistically significant difference in accuracy between the scores of 0.082 (95% confidence interval (CI): 0.040 - 0.125; P < 0.001) with the GRACE score (C statistics of 0.91; P < 0.001) having better accuracy compared to TIMI score (C statistics of 0.83; P < 0.001). This might be due to the fact that the GRACE scoring system has more detail and complete variables than the TIMI score. CONCLUSION: There is a significant difference between the accuracy of GRACE and TIMI scores in predicting in-hospital mortality in STEMI patients. The accuracy of the GRACE score is better than the TIMI score for predicting in-hospital mortality in STEMI patients.
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Martha et al. (2021) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=255). GRACE score vs. TIMI score was evaluated on Accuracy (Area Under the Curve) in predicting in-hospital mortality (ΔAUC 0.082, 95% CI 0.040 - 0.125, p=< 0.001). The GRACE score demonstrated significantly better accuracy than the TIMI score in predicting in-hospital mortality among STEMI patients, with an AUC difference of 0.082.
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