Vol. 6, Issue 2, Part A (2024)

Background: The most frequently employed scores in emergency rooms for patients with chest pain are the Thrombolysis in Myocardial Infarction (TIMI), Global Registry for Acute Coronary Events (GRACE), and Heart Score (HEART) Scores, which have been validated to predict adverse clinical outcomes. The purpose of this work was to evaluate the efficacy of TIMI, GRACE and HEART scores as predictors of Angiographic findings in non-ST elevation myocardial infarction (NSTEMI) patients and as predictors of short-term outcomes in NSTEMI patients.

Methods: This study was carried out at Tanta University Hospital's Cardiology Department. The study included 150 NSTEMI patients. There were three groups of fifty patients each, comprised of the selected patients:

Group (A): patients who were assessed using TIMI Score.

Group (B): patients who were assessed using GRACE Score and.

Group (C): Patients who were assessed using HEART Score. Coronary angiography was done to all patients and the angiographic complexity was calculated with SYNTAX score and complete revascularization was done to all patients.

A six-month follow-up was conducted on all patients to examine immediate outcomes (mortality, repeated hospitalization, Reinfection, Heart failure and Revascularization).

Results: 150 NSTEMI patients were enrolled and were subdivided into three groups with no statistical difference in demographic criteria between the three groups.

The three clinical scores were assessed for their sensitivity and specificity in predicting a SYNTAX score of 32 or above. Regarding TIMI score, AUC was 0.766, Cutoff value was 3.5, Sensitivity was 100% and Specificity was 45.2%. Regarding GRACE score, AUC was 0.775, Cutoff value was 92.5, Sensitivity was 46.2% and Specificity was 89.2%. Regarding HEART score, AUC was 0.805, Cutoff value was 5.5, Sensitivity was 66.7% and Specificity was 78.7%.

Conclusion: Syntax score was positively correlated with clinical risk score. The TIMI risk score is a useful negative screening tool for excluding individuals with high syntax scores, and the HEART and GRACE together provide excellent accuracy for identifying angiographic coronary artery complexity in NSTE MI patients.

Patients with NSTE MI had good short-term prognoses predicted by the clinical risk ratings.