title: Accuracy of the GRACE and TIMI scores in predicting the angiographic severity of acute coronary syndrome.
abstract: BACKGROUND
  The accuracy of the GRACE and TIMI scores in predicting coronary disease extension in patients with non-ST-elevation acute coronary syndromes (ACS) has not been established.
  
  
  OBJECTIVE
  To assess the hypothesis that the GRACE and TIMI risk scores satisfactorily predict coronary disease extension in patients withnon-ST-elevation ACS undergoing coronary angiography.
  
  
  METHODS
  Individuals meeting the objective criteria for ACS and undergoing coronary angiography during hospitalization were consecutively assessed. Angiographic coronary disease was described as follows: quantification of coronary disease extension by using Gensini score; presence of any coronary artery obstruction (> 70% or > 50% when affecting left main coronary artery); and presence of severe disease (three-vessel disease or affecting the left main coronary artery).
  
  
  RESULTS
  Of 112 patients assessed, a positive correlation of the Gensini score was observed with the GRACE (p = 0.017) and TIMI (p = 0.02) scores, but that association was weak (r = 0.23 and r = 0.27; respectively). The GRACE score could predict neither obstructive coronary disease (area under the ROC curve = 0.57; 95% CI = 0.46 - 0.69), nor severe coronary disease (ROC = 0.59; 95% CI = 0.48 - 0.70). The TIMI score proved to be a modest predictor of coronary disease (ROC = 0.65; 95% CI = 0.55 - 0.76) and of severe coronary disease (ROC = 0.66; 95% CI = 0.56 - 0.76).
  
  
  CONCLUSIONS
  (1) There is a positive association between the values of the TIMI or GRACE scores and the extension of coronary artery disease in patients with ACS; (2) however, the degree of that association is not sufficient to make those scores accurate predictors of coronary angiography results.
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Hospital São Rafael, Hospital Português, Salvador, BA - Brazil.
authors.forename: Carolina Esteves
authors.initials: CE
authors.lastname: Barbosa
authors.forename: Mateus
authors.initials: M
authors.lastname: Viana
authors.forename: Mariana
authors.initials: M
authors.lastname: Brito
authors.forename: Michael
authors.initials: M
authors.lastname: Sabino
authors.forename: Guilherme
authors.initials: G
authors.lastname: Garcia
authors.forename: Mayara
authors.initials: M
authors.lastname: Maraux
authors.forename: Alexandre Costa
authors.initials: AC
authors.lastname: Souza
authors.forename: Márcia
authors.initials: M
authors.lastname: Noya-Rabelo
authors.forename: J Péricles
authors.initials: JP
authors.lastname: Esteves
authors.forename: Luis Cláudio Lemos
authors.initials: LC
authors.lastname: Correia
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index