Utility of Global Registry of Acute Coronary Event Score (GRACE) and Thrombolysis in Myocardial Infarction Risk Score (TIMI Score) in predicting 30-day Mortality in patients undergoing primary angioplasty at a Tertiary care center – A record-based study

Abstract

Background This research work aims to assess the effectiveness of Global Registry Of Coronary Events (GRACE) and Thrombolysis In Myocardial Infarction (TIMI) risk scores in predicting outcomes for patients who underwent primary Percutaneous Coronary Intervention (PCI). The study included a cohort from a tertiary care centre. Methods This record-based study enrolled 94 patients who underwent primary PCI after a diagnosis of ST segment elevation myocardial infarction (STEMI). The data, for this study, was extracted from sources including, medical records. These records contained the computation and documentation of both GRACE and TIMI scores. The study also conducted Receiver Operating Curve (ROC) curve analysis, subsequently yielding the area under the curve alongside a 95% confidence interval, which was duly reported. Results The current study attempts a comparative analysis of the capacities of TIMI and GRACE scores. Accordingly, the study highlights that both are equally effective in predicting 30-day mortality for patients with STEMI. The TIMI Risk Score, with 85% sensitivity and 99% specificity metrics (also p-value = 0.008), and the GRACE Score, with 85% sensitivity and 99% specificity metrics (also p-value = 0.006), exhibit a strong similarity in the prognostic performance. Also, the sensitivity and specificity metrics were obtained after a thorough analysis of the receiver operating characteristic curve (ROCC). Conclusions The study utilized the TIMI score which demonstrated a sensitivity of 85% and specificity of 99% and the GRACE Score with 85% sensitivity and 99% specificity to predict 30-day mortality in STEMI patients. This included more than one month of observation period. Post observations, the results of the experiment suggested an improvement in the left ventricular functionwhich helped to infer that recovery after primary PCI is gradual rather than an immediate and pronounced recovery.