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Croatian Medical Journal, Vol. 58 No. 6, 2017.

Original scientific paper

https://doi.org/10.3325/cmj.2017.58.406

Comparison of RISK-PCI, GRACE, TIMI risk scores for prediction of major adverse cardiac events in patients with acute coronary syndrome

Tamara Jakimov orcid id orcid.org/0000-0002-7034-6790 ; Department of Cardiology, Clinical and Hospital Center “Bežanijska Kosa”, Belgrade, Serbia
Igor Mrdović ; Emergency Center, Clinical Center of Serbia and Faculty of Medicine,University of Belgrade, Belgrade, Serbia
Branka Filipović ; Emergency Center, Clinical Center of Serbia and Faculty of Medicine,University of Belgrade, Belgrade, Serbia
Marija Zdravković ; Department of Cardiology, Clinical and Hospital Center “Bežanijska kosa” and Faculty of Medicine University of Belgrade, Belgrade, Serbia
Aleksandra Djoković ; Department of Cardiology, Clinical and Hospital Center “Bežanijska kosa” and Faculty of Medicine University of Belgrade, Belgrade, Serbia
Saša Hinić ; Department of Cardiology, Clinical and Hospital Center “Bežanijska Kosa”, Belgrade, Serbia
Nataša Milić ; Institute for Medical Statistics and Faculty of Medicine, University ofBelgrade, Belgrade, Serbia
Branislav Filipović ; Institute of Anatomy “Niko Miljanić” and Faculty of Medicine, Universityof Belgrade, Belgrade, Serbia

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Abstract

Aim To compare the prognostic performance of three major
risk scoring systems including global registry for acute
coronary events (GRACE), thrombolysis in myocardial infarction
(TIMI), and prediction of 30-day major adverse cardiovascular
events after primary percutaneous coronary
intervention (RISK-PCI).
Methods This single-center retrospective study involved
200 patients with acute coronary syndrome (ACS) who
underwent invasive diagnostic approach, ie, coronary
angiography and myocardial revascularization if appropriate,
in the period from January 2014 to July 2014. The
GRACE, TIMI, and RISK-PCI risk scores were compared for
their predictive ability. The primary endpoint was a composite
30-day major adverse cardiovascular event (MACE),
which included death, urgent target-vessel revascularization
(TVR), stroke, and non-fatal recurrent myocardial infarction
(REMI).
Results The c-statistics of the tested scores for 30-day
MACE or area under the receiver operating characteristic
curve (AUC) with confidence intervals (CI) were as follows:
RISK-PCI (AUC = 0.94; 95% CI 1.790-4.353), the GRACE score
on admission (AUC = 0.73; 95% CI 1.013-1.045), the GRACE
score on discharge (AUC = 0.65; 95% CI 0.999-1.033). The
RISK-PCI score was the only score that could predict TVR
(AUC = 0.91; 95% CI 1.392-2.882). The RISK-PCI scoring system
showed an excellent discriminative potential for 30-
day death (AUC = 0.96; 95% CI 1.339-3.548) in comparison
with the GRACE scores on admission (AUC = 0.88; 95% CI
1.018-1.072) and on discharge (AUC = 0.78; 95% CI 1.000-
1.058).
Conclusions In comparison with the GRACE and TIMI
scores, RISK-PCI score showed a non-inferior ability to predict
30-day MACE and death in ACS patients. Moreover,
RISK-PCI was the only scoring system that could predict recurrent
ischemia requiring TVR.

Keywords

Hrčak ID:

200219

URI

https://hrcak.srce.hr/200219

Publication date:

28.12.2017.

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