title: Comparison of the GRACE risk score and the TIMI risk index in predicting the extent and severity of coronary artery disease in patients with acute coronary syndrome.
abstract: OBJECTIVE
  The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) has been reported in coronary artery disease (CAD) patients. We aimed to evaluate the relationship between the GRS, TRI, and severity of CAD evaluated by SYNTAX score (SS) in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  Patients with ACS who were admitted to the coronary care unit of our institution were retrospectively evaluated in this study. A total of 287 patients with ACS [154 non-ST elevated ACS (NSTE-ACS), 133 ST elevated myocardial infarction (STEMI)] were included in the study. The GRS and TRI were calculated on admission using specified variables. The severity of CAD was evaluated using the SS. The patients were divided into low (GRS<109)-, intermediate (GRS 109-140)-, and high (GRS>140)-risk groups and group 1 (TRI<17), group 2 (TRI 17-26), and group 3 (TRI>26) according to GRS and TRI scores. A Pearson correlation analysis was used for the relation between GRS, TRI, and SS.
  
  
  RESULTS
  Patients with a history of coronary artery bypass surgery, those who had missing data for calculating the GRS and TRI, and those whose systolic blood pressure (SBP) was more than 180 mm Hg or whose diastolic blood pressure (DBP) was more than 110 mm Hg were excluded from the study. Were excluded from the study. There were significant differences in mean age (p<0.001), heart rate (p<0.001), SS (p<0.001), TRI (p<0.001), rate of NSTE-ACS (p<0.001), and STEMI (p<0.001) in all patients between the risk groups. There was a positive significant correlation between the GRS and the SS (r=0.427, p<0.001), but there were no significant correlation between the TRI and SS (r=0.121, p=0.135). The area under the ROC curve value for GRS was 0.65 (95% CI: 0.56-0.74, p=0.001) in the prediction of severity of CAD.
  
  
  CONCLUSIONS
  The GRS is more associated with SS than TRI in predicting the severity of CAD in patients with ACS.
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University, Faculty of Medicine; Çanakkale-Turkey. adembekler27@gmail.com.
authors.forename: Adem
authors.initials: A
authors.lastname: Bekler
authors.forename: Burak
authors.initials: B
authors.lastname: Altun
authors.forename: Emine
authors.initials: E
authors.lastname: Gazi
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temiz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Barutçu
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Güngör
authors.forename: Muhammed Turgut Alper
authors.initials: MT
authors.lastname: Özkan
authors.forename: Sedat
authors.initials: S
authors.lastname: Özcan
authors.forename: Sabri
authors.initials: S
authors.lastname: Gazi
authors.forename: Bahadır
authors.initials: B
authors.lastname: Kırılmaz
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides