Acurácia dos escores GRACE e TIMI na predição da gravidade angiográfica da síndrome coronariana aguda

Barbosa, Carolina; Viana, Mateus dos Santos; Brito, Mariana; Sabino, Michael; Garcia, Guilherme; Maraux, Mayara; Souza, Alexandre C.; Noya-Rabelo, Márcia; Esteves, J. Péricles; Correia, Luís Cláudio Lemos

doi:10.1590/s0066-782x2012005000080

Cited by 23 publications

(20 citation statements)

References 22 publications

(24 reference statements)

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“…In the CHA 2 DS 2 -VASc-HS scoring system, age of ≥75 years is assigned 2 points, and male gender, smoking, HL, and congestive heart failure are included in the equation to improve the reliability of the scoring system. In previous studies ( 24 , 25 ), the relationships between the TIMI or GRACE scores and the extent of CAD in patients with NSTE-ACS were evaluated. The TIMI and GRACE scores are useful for the initial stratification of NSTE-ACS patients but are not optimized for patients undergoing PCI.…”

Section: Discussionmentioning

confidence: 99%

CHA2DS2-VASc-HS score in non-ST elevation acute coronary syndrome patients: assessment of coronary artery disease severity and complexity and comparison to other scoring systems in the prediction of in-hospital major adverse cardiovascular events

et al. 2016

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Objective:We recently described the CHA2DS2-VASc-HS score as a novel predictor of coronary artery disease (CAD) severity in stable CAD patients. We aimed to assess the accuracy of the CHA2DS2-VASc-HS score in the determination of CAD severity and complexity and its availability in the risk stratification of in-hospital major adverse cardiovascular events (MACE) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients.Methods:We prospectively analyzed the clinical and angiographic data of consecutive NSTE-ACS patients in our clinic. Patients were classified into three tertiles according to their SYNTAX score (SS): tertile 1 had an SS of 0–22; tertile 2 had an SS of 23–32; and tertile 3 had an SS of >32. There were no specific exclusion criteria except for previous coronary artery bypass grafting (CABG) because SS was validated for only native coronary arteries for this study. We used the following analyses: χ2 or Fisher’s exact tests, one-way analysis of variance or Kruskal–Wallis tests, Pearson’s or Spearman’s tests, the receiver operating characteristics (ROC) curve analysis, the area under the curve (AUC) or C-statistic, and pairwise comparisons of the ROC curves.Results:A total of 252 patients were enrolled. There were 131 patients in tertile 1, 79 in tertile 2, and 42 in tertile 3. The number of diseased vessels was correlated with the Global Registry for Acute Coronary Events (GRACE) (p<0.001), Thrombolysis in Myocardial Infarction (TIMI) (p<0.001), and CHA2DS2-VASc-HS (p<0.001) scores. In the ROC curve analyses, the cut-off value of the CHA2DS2-VASc-HS score in the prediction of in-hospital MACE was >5 with a sensitivity of 69.6% and specificity of 90.3% (AUC: 0.804, 95%: CI 0.750–0.851, p<0.001). We also compared the diagnostic accuracy of the CHA2DS2-VASc-HS score with the TIMI and GRACE risk scores in the determination of the in-hospital MACE and found no differences.Conclusion:The CHA2DS2-VASc-HS score was positively correlated with the severity and complexity of CAD. We also found that CHA2DS2-VASc-HS was comparable with other risk scores for the risk stratification of the in-hospital MACE of NSTE-ACS patients. Therefore, it may play an important role as a predictive model of NSTE-ACS patients in clinical practice. (Anatol J Cardiol 2016; 16: 742-8)

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Section: Discussionmentioning

confidence: 99%

CHA2DS2-VASc-HS score in non-ST elevation acute coronary syndrome patients: assessment of coronary artery disease severity and complexity and comparison to other scoring systems in the prediction of in-hospital major adverse cardiovascular events

et al. 2016

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“…These results were confirmed in the retrospective study of Ben Salem et al (22). Also, in another study, the relationship between GRS, TIMI risk score, and Gensini score was investigated in patients with NSTE-ACS, and a positive significant correlation was observed between GRS and Gensini score, but it has been shown that this significance was not sufficient for GRS to predict obstructive CAD (23). …”

Section: Discussionmentioning

confidence: 99%

Comparison of the GRACE risk score and the TIMI risk index in predicting the extent and severity of coronary artery disease in patients with acute coronary syndrome

Bekler

Altun

Gazı³

et al. 2015

Anatol J Cardiol

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Objective:The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) has been reported in coronary artery disease (CAD) patients. We aimed to evaluate the relationship between the GRS, TRI, and severity of CAD evaluated by SYNTAX score (SS) in patients with acute coronary syndrome (ACS).Methods:Patients with ACS who were admitted to the coronary care unit of our institution were retrospectively evaluated in this study. A total of 287 patients with ACS [154 non-ST elevated ACS (NSTE-ACS), 133 ST elevated myocardial infarction (STEMI)] were included in the study. The GRS and TRI were calculated on admission using specified variables. The severity of CAD was evaluated using the SS. The patients were divided into low (GRS<109)-, intermediate (GRS 109-140)-, and high (GRS>140)-risk groups and group 1 (TRI<17), group 2 (TRI 17-26), and group 3 (TRI>26) according to GRS and TRI scores. A Pearson correlation analysis was used for the relation between GRS, TRI, and SS.Results:Patients with a history of coronary artery bypass surgery, those who had missing data for calculating the GRS and TRI, and those whose systolic blood pressure (SBP) was more than 180 mm Hg or whose diastolic blood pressure (DBP) was more than 110 mm Hg were excluded from the study. Were excluded from the study. There were significant differences in mean age (p<0.001), heart rate (p<0.001), SS (p<0.001), TRI (p<0.001), rate of NSTE-ACS (p<0.001), and STEMI (p<0.001) in all patients between the risk groups. There was a positive significant correlation between the GRS and the SS (r=0.427, p<0.001), but there were no significant correlation between the TRI and SS (r=0.121, p=0.135). The area under the ROC curve value for GRS was 0.65 (95% CI: 0.56-0.74, p=0.001) in the prediction of severity of CAD.Conclusion:The GRS is more associated with SS than TRI in predicting the severity of CAD in patients with ACS.

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“…The clinical variables present in this model reflect the patient's degree of vulnerability to the insult presented in an ACS and, despite predicting anatomical complexity, it does not have a good predictive accuracy, according to data previously demonstrated by our group. [19][20][21] The current study has not been able to demonstrate an association between the GRACE score and the occurrence of new non-fatal ischemic events.…”

Section: Discussionmentioning

confidence: 88%

Competência Prognóstica Distinta entre Modelo Clínico e Anatômico em Síndromes Coronarianas Agudas: Comparação por Tipo de Desfecho

Viana

Correia

Ferreira

et al. 2020

Arquivos Brasileiros De Cardiologia

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Background: Recurrent ischemic events are mediated by atherosclerotic plaque instability, whereas death after an ischemic event results from gravity of insult and ability of the organism to adapt. The distinct nature of those types of events may respond for different prediction properties of clinical and anatomical information regarding type of outcome. Objective: To identify prognostic properties of clinical and anatomical data in respect of fatal and non-fatal outcomes of patients hospitalized with acute coronary syndromes (ACS). Methods: Patients consecutively admitted with ACS who underwent coronary angiography were recruited. The SYNTAX score was utilized as an anatomic model and the GRACE score as a clinical model. The predictive capacity of those scores was separately evaluated for prediction of non-fatal ischemic outcomes (infarction and refractory angina) and cardiovascular death during hospitalization. It was considered as significant a p-value <0,05. Results: EAmong 365 people, cardiovascular death was observed in 4,4% and incidence of non-fatal ischemic outcomes in 11%. For cardiovascular death, SYNTAX and GRACE score presented similar C-statistic of 0,80 (95% IC: 0,70-0,92) and 0,89 (95% IC 0,81-0,96), respectively-p = 0,19. As for non-fatal ischemic outcomes, the SYNTAX score presented a moderate predictive value (C-statistic = 0,64; 95%IC 0,55-0,73), whereas the GRACE score did not presented association with this type of outcome (C-statistic = 0,50; 95%IC 0,40-0,61)-p = 0,027. Conclusion: Clinical and anatomic models similarly predict cardiovascular death in ACS. However, recurrence of coronary instability is better predicted by anatomic variables than clinical data. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0

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Acurácia dos escores GRACE e TIMI na predição da gravidade angiográfica da síndrome coronariana aguda

Abstract: Background: The accuracy of the GRACE and TIMI scores in predicting coronary disease extension in patients with non-ST-elevation acute coronary syndromes (ACS) has not been established.

Cited by 23 publications

References 22 publications

CHA2DS2-VASc-HS score in non-ST elevation acute coronary syndrome patients: assessment of coronary artery disease severity and complexity and comparison to other scoring systems in the prediction of in-hospital major adverse cardiovascular events

CHA2DS2-VASc-HS score in non-ST elevation acute coronary syndrome patients: assessment of coronary artery disease severity and complexity and comparison to other scoring systems in the prediction of in-hospital major adverse cardiovascular events

Comparison of the GRACE risk score and the TIMI risk index in predicting the extent and severity of coronary artery disease in patients with acute coronary syndrome

Competência Prognóstica Distinta entre Modelo Clínico e Anatômico em Síndromes Coronarianas Agudas: Comparação por Tipo de Desfecho

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