Performance of the TIMI and GRACE scores in identifying the risk of death from acute coronary ischemic syndrome: a retrospective study in patients with chest pain at a Peruvian Hospital

Abstract

Background. Acute coronary syndrome (ACS) is one of the significant causes of death in the adult population globally, and mortality risk assessment is essential to improve prevention strategies. This study aimed to determine the performance of the TIMI and GRACE predictive models in identifying the risk of death from acute coronary syndrome (ACS) in patients with chest pain at a public hospital in Tumbes, Peru. Methods. We designed a retrospective cross-sectional study of medical records of patients with ACS treated at the José Alfredo Mendoza Olavarría Regional Hospital in Tumbes, Peru, from May to December 2022. The performance of the scores TIMI and GRACE for risk of death from ACS was evaluated using the receiver operating characteristic (ROC) curve analysis and calculating the area under the ROC curve (AUC) value with its 95% confidence interval. The AUC values of both scores were compared using Pearson's chi-square test. Results. Data from 106 patients were analyzed. The average age of the patients was 65 years (interquartile range [IQR]: 55-73), with 63.2% being male. The AUC values for the TIMI and GRACE scores were 95.1% (CI95: 90.9-99.2%) and 95.2% (85.7-100.0%), respectively, p=0.982. Conclusion. No difference was found in using the TIMI and GRACE scores to assess the risk of death in patients with ACS who attend a hospital for chest pain. Hence, either of the two scores would be helpful for the prognosis of death in patients with ACS.