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Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction
- Source :
- Arquivos Brasileiros de Cardiologia, Vol 103, Iss 2, Pp 98-106 (2014)
- Publication Year :
- 2014
- Publisher :
- Sociedade Brasileira de Cardiologia (SBC), 2014.
-
Abstract
- Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI) was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics) and calibration (Hosmer-Lemeshow) in relation to hospital death. Results: The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively), as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively). Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98), similar to GRACE (0.87, 95%CI = 0.75 to 0.99) - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92), well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08). This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively), differently to GRACE (2.4%, 25% and 73%), which featured middle range incidence inappropriately. Conclusion: Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.
Details
- Language :
- English, Portuguese
- ISSN :
- 16784170
- Volume :
- 103
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Arquivos Brasileiros de Cardiologia
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.0e6598b2f1c54a769c1b797b45bebd2e
- Document Type :
- article
- Full Text :
- https://doi.org/10.5935/abc.20140095