PREDICTION OF CORONARY ARTERY DISEASE EXTENT AND SEVERITY ON THE BASIS OF GRACE AND TIMI SCORES IN PATIENTS PRESENTED WITH

Abstract

Objective: To determine the correlation of Global Registry for Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) to predict the extent and severity of coronary artery disease (CAD) in patients presented with first onset STE levation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI).

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Inpatient departments of Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from Jan 2019 to Jun 2019.

Methodology: Ethical approval was taken from Institutional Ethical Review Board (IERB), AFIC/NIHD. Patients of any age and both genders who presented with chest pain and satisfied criteria for Type 1 Myocardial Infarction (MI), as stated in 4th Universal Definition of MI, were included in study by non-probability consecutive sampling technique. Patients with a previous history of ischemic heart disease, Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) surgery were excluded. Both TIMI and GRACE scores for STEMI were calculated at time of admission. The extent and severity of CAD were assessed by the SS-I. Each coronary lesion with a diameter stenosis of at least 50%, in vessels of at least 1.5 mm, were scored. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25.

Results: Out of 376 patients, 327 (86.9%) were male and 49 (13.1%) were female. Anterior wall MI was the most common presentation 164 (43.6%). Among risk factors for CAD, hypertension was the most common one 215 (57.2%). A positive correlation was found between SS and GRACE low, intermediate and high-risk groups (0.145).

Conclusion: Patients having high GRACE and TIMI scores were more likely to have severe CAD. In comparison with TIMI score, GRACE score was found to have better correlation with SS, but degree of that association was not strong enough to make it a reliable and sole predictor of CAD severity.