Predictive Accuracy of TIMI, HEART, and GRACE Scores for Coronary Artery Disease Severity in NSTEMI/Unstable Angina – A Prospective Study from an Academic Emergency Department in Rural India

Aim

Scoring systems used to risk stratify patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI)/ unstable angina (UA) for clinical decision-making in the Emergency Department (ED) are validated for outcomes, mortality, or adverse events but not evaluated for their predictive accuracy of the severity of coronary vessel involvement. With this objective, we studied how accurately Thrombolysis In Myocardial Infarction (TIMI), History, Electrocardiogram, Age, Risk Factors, Troponin (HEART), and Global Registry of Acute Coronary Events (GRACE) scores risk stratify patients with suspected NSTEMI/UA for the severity of coronary artery disease (CAD). Material and Methods: This was a prospective observational study of one year among patients who presented with UA and NSTEMI at a tertiary care teaching hospital ED in rural India. The primary outcome was quantified using the Gensini score following angiographic assessment of CAD severity.