Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos Brasileiros de Cardiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000003 |
Resumo: | 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. |
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Arquivos Brasileiros de Cardiologia (Online) |
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Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial InfarctionMyocardial InfarctionPropensity ScoreRisk FactorsComparative StudyAcute Coronary Syndrome / diagnosisPrognosis 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. Sociedade Brasileira de Cardiologia - SBC2014-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000003Arquivos Brasileiros de Cardiologia v.103 n.2 2014reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20140095info:eu-repo/semantics/openAccessCorreia,Luis C. L.Garcia,GuilhermeKalil,FelipeFerreira,FelipeCarvalhal,ManuelaOliveira,RuanSilva,AndréVasconcelos,IsisHenri,CaioNoya-Rabelo,Márciaeng2014-08-29T00:00:00Zoai:scielo:S0066-782X2014002000003Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2014-08-29T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
title |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
spellingShingle |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction Correia,Luis C. L. Myocardial Infarction Propensity Score Risk Factors Comparative Study Acute Coronary Syndrome / diagnosis Prognosis |
title_short |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
title_full |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
title_fullStr |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
title_full_unstemmed |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
title_sort |
Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction |
author |
Correia,Luis C. L. |
author_facet |
Correia,Luis C. L. Garcia,Guilherme Kalil,Felipe Ferreira,Felipe Carvalhal,Manuela Oliveira,Ruan Silva,André Vasconcelos,Isis Henri,Caio Noya-Rabelo,Márcia |
author_role |
author |
author2 |
Garcia,Guilherme Kalil,Felipe Ferreira,Felipe Carvalhal,Manuela Oliveira,Ruan Silva,André Vasconcelos,Isis Henri,Caio Noya-Rabelo,Márcia |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Correia,Luis C. L. Garcia,Guilherme Kalil,Felipe Ferreira,Felipe Carvalhal,Manuela Oliveira,Ruan Silva,André Vasconcelos,Isis Henri,Caio Noya-Rabelo,Márcia |
dc.subject.por.fl_str_mv |
Myocardial Infarction Propensity Score Risk Factors Comparative Study Acute Coronary Syndrome / diagnosis Prognosis |
topic |
Myocardial Infarction Propensity Score Risk Factors Comparative Study Acute Coronary Syndrome / diagnosis Prognosis |
description |
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. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000003 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/abc.20140095 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
dc.source.none.fl_str_mv |
Arquivos Brasileiros de Cardiologia v.103 n.2 2014 reponame:Arquivos Brasileiros de Cardiologia (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
Arquivos Brasileiros de Cardiologia (Online) |
collection |
Arquivos Brasileiros de Cardiologia (Online) |
repository.name.fl_str_mv |
Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
||arquivos@cardiol.br |
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1752126564686888960 |