Assessment of KILLIP, TIMI and GRACE SCORE in Predicting STEMI Mortality

Objectives Coronary artery disease is one of the leading causes of death in our country. The incidence of ST-elevation myocardial infarction (STEMI) is 1.34 million. We have scores such as thrombolysis in myocardial infarction ([TIMI], global registry of acute coronary events (GRACE), and KILLIP score to assess the mortality among the STEMI patients. The assessment of accuracy of these scores in predicting mortality in India is lacking. Our aim is to assess the accuracy, predictability, and reproducibility of these scores in the prognosis of STEMI patients. Materials and Methods 561 consecutive STEMI patients admitted between April 2022 and April 2023 in the cardiac intensive care unit of Chengalpattu Medical College were included in the study. These patients were assessed with TIMI, GRACE, and KILLIP score for mortality and were followed up for 1 year. The outcome of the patients was recorded and the accuracy of the scores in predicting mortality was assessed. Results Females comprised 25.13% of the study population and the mean age was 56.93 ± 11.87. Anterior wall myocardial infarction (AWMI) and inferior wall MI were found 58.11% and 41.89%, respectively. The predictive accuracy of these scores was evaluated using Statistics C Area under the curve for TIMI, KILLIP, and GRACE and they were 0.82, 0.85, and 0.86, respectively. The accuracy for diagnosis of TIMI >5, KILLIP >2, and GRACE >167 was 80.68, 88.57, and 83.58%, respectively. Conclusion The predictive accuracy for KILLIP and GRACE score was better than TIMI score. When all these risk scores were used, the accuracy of predicting mortality in STEMI patients was significantly higher.