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November 12, 2018Indian Heart Journal30 citationsOpen Access

GRACE and TIMI risk scores in predicting the angiographic severity of non-ST elevation acute coronary syndrome

SRSharadindu Shekhar RoySAS.T.M. Abu AzamMKMd. Khalequzzaman

Key Result

The GRACE risk score demonstrated superior accuracy compared to the TIMI risk score in predicting the angiographic severity of coronary artery disease, with an area under the ROC curve of 0.943 versus 0.892.

Study Design

Type

Cross-Sectional (n=205)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does the GRACE risk score improve the prediction of angiographic severity of coronary artery disease compared to the TIMI risk score in patients with non-ST elevation acute coronary syndrome?

P
Population
205 patients (mean age 51.8, 20% female) with non-ST elevation acute coronary syndrome, free of prior myocardial infarction or revascularization, evaluated during index hospitalization.
E
Exposure
GRACE risk score calculation
C
Comparator
TIMI risk score calculation
O
Outcome
Angiographic severity of coronary artery disease assessed by vessel score and Gensini scoresurrogate

The GRACE risk score is superior to the TIMI risk score in predicting the angiographic severity of coronary artery disease in patients with non-ST elevation acute coronary syndrome.

Main Result

Effect estimate: AUC 0.943 (95% CI 0.893-0.993)

Absolute Event Rate: 0.943% vs 0.892%

p-value: p=<0.001

Limitations

  • Conducted in a single center
  • Limited sample size to generalize the results
  • conducted in a single center
  • limited to generalize the results

Abstract

AIMS: We aimed to compare the GRACE and TIMI risk scores in patients with non- ST elevation acute coronary syndrome for their accuracy in predicting the angiographic severity of coronary artery disease. METHOD: The cross-sectional study done in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from April, 2015-April, 2016. The patients admitted with non-ST elevation acute coronary syndrome were evaluated to calculate the GRACE and TIMI risk score. Coronary angiogram was done during index hospitalization and the severity of coronary artery disease was assessed by vessel score and Gensini score. RESULTS: Of 205 patients, a positive correlation of the vessel score and Gensini score was observed with both the GRACE and TIMI risk scores (p = <0.001) and the GRACE score (r = 0.55) correlated better than the TIMI score (r = 0.51). The GRACE score presented area under the Receiver Operating Characteristic (ROC) curve (0.943; 95% CI = 0.893-0.993) significantly superior to the area under the ROC curve (0.892; 95% CI = 0.853-0.937) of the TIMI score. CONCLUSION: Both the GRACE and TIMI risk scores had good predictive value in assessment the severity of coronary artery disease in patients with non-ST elevation acute coronary syndrome, when they were compared, the GRACE score was found to be superior to the TIMI score.

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Cite This Study

Roy et al. (2018) conducted a cross-sectional in Non-ST elevation acute coronary syndrome (n=205). GRACE risk score vs. TIMI risk score was evaluated on Area under the ROC curve for predicting angiographic severity of coronary artery disease (AUC 0.943, 95% CI 0.893-0.993, p=<0.001). The GRACE risk score demonstrated superior accuracy compared to the TIMI risk score in predicting the angiographic severity of coronary artery disease, with an area under the ROC curve of 0.943 versus 0.892.

synapsesocial.com/papers/6a203b9645d96add4db5d6e6https://doi.org/10.1016/j.ihj.2018.01.026
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