Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better

Abstract

Compared with TIMI RS, both PURSUIT RS and GRACE RS allow better discrimination for in-hospital and 1 year mortality in patients presenting with a wide range of ACS. All three risk scores confer additional important prognostic value beyond global risk assessment by physicians. These validated risk scores may refine risk stratification, thereby improving patient care in routine clinical practice.

Midregional Proadrenomedullin Predicts Mortality and Major Adverse Cardiac Events in Patients Presenting With Chest Pain: Results From the CHOPIN Trial

“…Several risk scores have been developed, including Thrombolysis in Myocardial Infarction (TIMI); [4][5][6] Global Registry of Acute Coronary Events (GRACE); [7][8][9][10] Fast Revascularisation in Instability in Coronary disease (FRISC); 11 and History, ECG, Age, Risk factors, and Troponin (HEART), 12,13 to identify which patients with chest pain of cardiac etiology are at higher risk for worse cardiovascular outcomes and mortality. These scores are derived from overlapping clinical variables recorded at time of evaluation, including age, vital signs, comorbidities, and biomarkers.…”

Thrombolysis in myocardial infarction (TIMI) risk score validation in Saudi Arabia

“…TIMI risk score was derived from clinical trial populations and was validated internally and externally in some populations (9). It has been compared with other risk scores and has consistently been found to have good performance and, more importantly, it can be used to predict in hospital mortality, which was the main outcome in our population (10). Due to the presence of differences between the TIMI cohort in the clinical trials from which it was developed and our population, it was necessary to be validated to determine its generalizability and applicability on Saudi population (14).…”

“…The TIMI risk score was shown to provide good discrimination in predicting in hospital and 1-year mortality (10). This offers some evidence for its clinical applicability in risk stratification and prognostication.…”

Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain

“…Risk scoring systems -including the Thrombolysis in Myocardial Infarction (TIMI) 5 and Global Registry of Acute Coronary Events (GRACE) 6 scores -have been validated to confer additional important prognostic value. 7 Triage is often based upon myocardial perfusion imaging 8 or other forms of stress testing. 9 A scientific statement of the American Heart Association (AHA) supports expedited management of low-risk chest pain patients by combining clinical and laboratory assessments with a confirmatory stress test as "safe, accurate and cost-effective".…”