Key result
The GRACE risk score effectively predicted a high-risk SYNTAX score (>33) in NSTEMI patients (AUC 0.804; 95% CI 0.660-0.948; p=0.002), whereas the TIMI score showed no predictive capacity.
Why the study?
Do GRACE and TIMI risk scores correlate with the severity and extent of coronary artery disease (SYNTAX score) in patients with NSTEMI?
Cross-Sectional (n=145)
No
Do GRACE and TIMI risk scores correlate with the severity and extent of coronary artery disease (SYNTAX score) in patients with NSTEMI?
Effect estimate: AUC 0.804 (95% CI 0.660-0.948)
p-value: p=0.002
The GRACE risk score correlates significantly with the SYNTAX score and demonstrates good discriminatory capacity for identifying severe, extended coronary artery disease in patients with NSTEMI.
GRACE outperforms TIMI for predicting CAD severity in NSTEMI; supports preferential clinical use and further head-to-head validation.
Objective: We aimed to assess the correlation of TIMI and GRACE risk scores with the SYNTAX score as the surrogate of severity and extent of coronary artery disease.Methods: Patients with non-ST elevation myocardial infarction admitted to our emergency department and undergoing coronary angiography were considered for this study. TIMI and GRACE risk scores were calculated, and coronary artery disease severity and extension were assessed by using the SYNTAX score algorithm.Results: We assessed 145 patients (mean age 59.41±11.04 years, 29% female). Based on the GRACE risk score for in-hospital deaths, the SYNTAX risk score was 12.22±8.70 for the low-risk group, 16.66±8.01 for the intermediate-risk group, and 22.48±11.42 for the high-risk group (ANOVA, p<0.0001). There were significant positive correlations between the SYNTAX score and GRACE scores (r=0.414, p<0.0001). The SYNTAX score also had a significant but weaker correlation with the TIMI score (r=0.271, p=0.001). The GRACE score showed good discriminatory capacity between the patients with and without a high-risk (>33) SYNTAX score, with an area under the ROC curve of 0.804 (CI 0.660-0.948, p=0.002); however, the TIMI score showed no predictive capacity and had an area under the ROC curve of 0.532 (CI 0.358-0.749, p=0.749).Conclusion: A GRACE score indicating high risk may be helpful in predicting patients with severe extended coronary artery diseaseKey words: Coronary artery disease, non-ST elevation myocardial infarction, risk scores
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Öner et al. (2015) conducted a cross-sectional in non-ST elevation myocardial infarction (n=145). GRACE risk score vs. TIMI risk score was evaluated on High-risk (>33) SYNTAX score (AUC 0.804, 95% CI 0.660-0.948, p=0.002). The GRACE risk score effectively predicted a high-risk SYNTAX score (>33) in NSTEMI patients (AUC 0.804; 95% CI 0.660-0.948; p=0.002), whereas the TIMI score showed no predictive capacity.
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