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To assess the correlation of TIMI and GRACE risk scores with the SYNTAX score as the surrogate of severity and extent of coronary artery disease in patients with non-ST segment elevation myocardial infarction (NSTEMI).
Patients admitted to our emergency department with chest pain, meeting the criteria of NSTEMI and undergoing coronary angiography during hospitalisation were considered for this study. Patients with ST segment elevation at admission, new left bundle branch block, percutaneous coronary intervention in the previous 6 months or previous coronary artery bypass graft surgery were excluded. TIMI and GRACE risk scores were calculated and coronary artery disease severity and extension were assessed by an experienced invasive cardiologist using the SYNTAX score algorithm.
We assessed 145 patients (mean age 59.41±11.04 years, 29% female). A positive correlation of the SYNTAX score was observed with GRACE scores for in-hospital death, in-hospital death or MI, death at 6 month and death or MI at 6 month (r=0,414, p<0.0001; r=0,370, p<0.0001; r=0,417, p<0.0001; r=0,415, p<0.0001, respectively). The SYNTAX score also had a significant but weaker correlation with the TIMI score(r=0,271, p=0.001). The GRACE score showed good discriminatory capacity between the patients with and without a high-risk (>33) SYNTAX score, with an area under the ROC curve of 0.804 (CI 0.660–0.948, p=0.002); however, the TIMI score showed no predictive capacity and had an area under the ROC curve of 0.532 (CI 0.358–0.749, p=0.749).
There is a positive association between GRACE, TIMI scores and SYNTAX score in patients with NSTEMI. GRACE scores but not TIMI score can predict the patients with high risk SYNTAX score (>33).