Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction

Detalhes bibliográficos
Autor(a) principal: Correia,Luis C. L.
Data de Publicação: 2014
Outros Autores: Garcia,Guilherme, Kalil,Felipe, Ferreira,Felipe, Carvalhal,Manuela, Oliveira,Ruan, Silva,André, Vasconcelos,Isis, Henri,Caio, Noya-Rabelo,Márcia
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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spelling 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
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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
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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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