GRACE and TIMI scores in predicting the extension of coronary artery disease in patients with non-ST elevation myocardial infarction

Öz

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 disease

Key words: Coronary artery disease, non-ST elevation myocardial infarction, risk scores

Anahtar Kelimeler

• Coronary artery disease, non-ST elevation myocardial infarction, risk scores

ST yükselmesiz miyokard enfarktüsü hastalarında koroner arter hastalığı yaygınlığının GRACE ve TIMI skorlarıyla öngörülmesi

Öz

Amaç: TIMI ve GRACE risk skorlarının koroner arter hastalığının ciddiyetinin ve yaygınlığının bir göstergesi olan SYNTAX skoru ile korelasyonunu değerlendirmeyi amaçladık.Yöntemler: ST elevasyonsuz miyokard infarktüsü nedeniyle acilimize başvuran ve koroner anjiyografi yapılan hastalar çalışmaya alındı. TIMI ve GRACE risk skorları hesaplandı, koroner arter hastalığının ciddiyeti ve yaygınlığı SYNTAX skor algoritması kullanılarak değerlendirildi.Bulgular: 145 hastayı (ortalama yaş 59,41±11.04 yıl, %29 bayan) değerlendirdik. GRACE risk skoru baz alındığında hastane içi ölüm için düşük riskli grupta SYNTAX skoru 12,22±8,70, orta riskli olanlarda 16,66±8,01, yüksek riskli olanlarda 22,48±11,42 idi (ANOVA, p<0,0001). SYNTAX skorları ve GRACE skorları arasında anlamlı pozitif korelasyon vardı (r=0,414, p<0,0001). SYNTAX skoru ile TIMI skoru arasında anlamlı ama daha zayıf bir korelasyon vardı (r=0,271, p=0,001). GRACE skoru yüksek (>33) SYNTAX skoru olan ve olmayan hastalar için iyi bir ayırt etme kapasitesi göstermiştir, ROC eğrisi altında alan 0,804 (CI 0,660-0,948, p=0,002); fakat TIMI skoru ayırt etme kapasitesi göstermedi, ROC eğrisi altındaki alan 0,532 (CI 0,358-0,749, p=0,749) idi.Sonuç: Yüksek GRACE risk skoru ciddi ve yaygın koroner arter hastalığı olan hastaları öngörmede faydalı olabilir

Anahtar Kelimeler

• Koroner arter hastalığı, ST elevasyonsuz miyokard infarktüsü, risk skoru

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