Performance of Prognostic Scoring Systems in MINOCA: A Comparison among GRACE, TIMI, HEART, and ACEF Scores

Figures

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  Figure 1. Flowchart of the study. Abbreviations: AMIPE = Acute Myocardial Infarction, Prognostic, and Therapeutic Evaluation; CAD = coronary artery disease; ICA = invasive coronary angiography; MINOCA = myocardial infarction with non-obstructive coronary arteries.

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  Figure 2. ROC curves. Panel (A). ROC curves comparing GRACE, TIMI, HEART, and ACEF scores in predicting long-term all-cause death or AMI (after 1 year). Panel (B). ROC curves comparing GRACE, TIMI, HEART, and ACEF scores in predicting long-term all-cause death. Abbreviations: 95% CI = 95% confidence interval; AMI = acute myocardial infarction; AUC = area under the curve.

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  Figure 3. Alluvial plot showing mutual relationships among risk class identified by GRACE, TIMI, HEART, and ACEF scores. Panel (A). High-risk class by TIMI if >2; high-risk class by GRACE if >171. Panel (B). High-risk class by HEART if >5. Panel (C). High-risk class by ACEF if >1.16.

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  Figure 4. Kaplan–Meier curves showing event-free survival (death or acute myocardial infarction) in risk categories as defined per the best cut-off identified for GRACE, TIMI, HEART, and ACEF scores.

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  Figure 5. Stacked bar plot showing the relative mean weight of each item in determining the maximum GRACE, TIMI, HEART, and ACEF score per patient. Of note, the weight of items included in the ACEF score was estimated to be 50% for either age or LVEF since it was calculated as age/LVEF (+1 if serum creatinine >2 mg/dL) and only a small percentage of patients had serum creatinine >2 mg/dL. Abbreviations: ASA = acetylsalicylic acid; CVR = cardiovascular risk factors; HR = heart rate; LVEF = left ventricle ejection fraction; NSTE-ACS = non-ST-elevation acute coronary syndrome; SBP = systolic blood pressure.