In NSTEMI patients, GRACE and HEART scores predicted in-hospital death (AUC 0.90, 0.89) and cardiogenic shock better than TIMI score (AUC 0.84 death).
Do the GRACE and HEART risk scores better predict in-hospital outcomes compared to the TIMI risk score in patients with NSTEMI?
In patients with NSTEMI, the HEART and GRACE risk scores demonstrated superior predictive accuracy for in-hospital outcomes, including death and cardiogenic shock, compared to the TIMI risk score.
Abstract Background A major component of ACS, Non-ST segment elevation myocardial infarction (NSTEMI), has more than twice the incidence compared to ST-segment elevation myocardial infarction (STEMI). However, NSTEMI patients have a large range of clinical consequences, from minimal sequelae to early death. Risk assessment was crucial in guiding therapeutic decision-making. Three well-known risk scores are the GRACE score, the HEART score and the TIMI score. Purpose To compare the performance of the GRACE, HEART and TIMI scores in predicting the in hospital outcome among the NSTEMI patients Methods This prospective, observational, single-center study, was conducted for one year (November ,23 to October,24). Total 588 patients who admitted with Chest pain respectively; p 0.001. For Cardiogenic shock, The AUC of GRACE, HEART, and TIMI 0.78(95%CI 0.71-0.86), versus 0.70 (95% CI 0.63-0.77) versus 0.67(95%CI 0.59-0.76)); respectively; p 0.001. For in hospital Death, The AUC of GRACE, HEART, and TIMI score are 0.90(95%CI 0.874-0.940), versus 0.89 (95% CI 0.84-0.94) versus 0.84 (95% CI 0.820-0.923); respectively; p 0.001 (all differences in AUC highly statistically significant). Conclusion In patients with NSTEMI, the HEART and GRACE risk scores can better predict in hospital outcome than the TIMI risk score.ROC curve for prection of ALVF ROC curve for prediction of Death
Chowdhury et al. (2025) studied this question. In NSTEMI patients, GRACE and HEART scores predicted in-hospital death (AUC 0.90, 0.89) and cardiogenic shock better than TIMI score (AUC 0.84 death).