Key result
TIMI score yields ~0.70 AUC, outperforming GRACE for predicting significant coronary lesions in NSTE-ACS.
Why the study?
The literature lacks studies regarding the correlation between risk scores and coronary anatomy in acute coronary syndrome.
Do TIMI and GRACE risk scores predict the presence of significant coronary lesions (≥ 50%) in patients with non-ST-elevation acute coronary syndrome?
Observational (n=582)
Do TIMI and GRACE risk scores predict the presence of significant coronary lesions (≥ 50%) in patients with non-ST-elevation acute coronary syndrome?
Answers are grounded in this paper and cite their sources.
The TIMI risk score correlates better with the presence of significant coronary lesions (≥ 50%) than GRACE scores in patients with non-ST-elevation acute coronary syndrome.
BACKGROUND: The literature lacks studies regarding the correlation between risk scores and coronary anatomy in acute coronary syndrome (ACS) OBJECTIVE: Correlate risk scores with the severity of the coronary lesion in ACS with non-ST elevation. METHODS: A total of 582 patients were analyzed between July 2004 and October 2006. The correlation between TIMI risk scores and GRACE (hospital and six months) scores was performed for patients with coronary lesion ≥ 50%, using Spearman's non-parametric method. Multiple regression logistics was used to determine the predictive ability of the scores to discriminate to discriminate who will have a coronary lesion ≥ 50%. RESULTS: Most subjects were male (319 or 54.8%), mean age of 59.9 (± 10.6) years. A positive correlation was observed between risk scores and coronary lesion ≥ 50% (TIMI r = 0.363 [p < 0.0001]; hospital GRACE r = 0.255 [p < 0.0001]; GRACE at six months r = 0.209 [< 0.0001]). The area under the ROC curve for each score to determine to discriminate who will have a coronary lesion > 50% was: TIMI = 0.704 [CI95% 0.656-0.752; p <0.0001]; hospital GRACE = 0.623 [CI95% 0.573-0.673; p < 0.0001]; GRACE at six months= 0.562 [CI95% 0.510-0.613; p ;= 0.0255]. Comparing the areas under the ROC curve, it was found: TIMI versus hospital GRACE: p = 0.01; TIMI versus GRACE at six months:p < 0.0001; hospital GRACE versus GRACE at six months: p = 0.0461. CONCLUSION: Risk scores correlate with the severity of coronary lesions, and the TIMI risk score showed the best predictive ability.
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Santos et al. (2013) conducted an observational in Non-ST-elevation acute coronary syndrome (n=582). TIMI and GRACE risk scores was evaluated on Predictive ability to discriminate a coronary lesion ≥ 50% (Area under the ROC curve) (AUC 0.704, 95% CI 0.656-0.752, p=<0.0001). The TIMI risk score showed the best predictive ability to discriminate a coronary lesion ≥ 50% in non-ST-elevation ACS, outperforming GRACE scores.
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