HEART versus GRACE Score in Predicting the Outcomes of Patients with Acute Coronary Syndrome, a Systematic Review and Meta-Analysis

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Kabiri Ali; Gharin Pantea; Forouzannia Seyed Ali; Ahmadzadeh Koohyar; MIRI REZA; YOUSEFIFARD MAHMOUD

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Journal: Archives of Academic Emergency Medicine Year:621 | Volume: | Issue: Page(s): 0-0

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Title

HEART versus GRACE Score in Predicting the Outcomes of Patients with Acute Coronary Syndrome, a Systematic Review and Meta-Analysis

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Keywords

Acute coronary syndrome

risk assessment

sensitivity

specificity

decision tools

Abstract

Introduction: Several scoring systems have been proposed to predict the outcomes of patients with ischemic heart disease. Global Registry of Acute Coronary Events (GRACE) and History, ECG, Age, Risk Factors, and Troponin (HEART) scores are two of the more widely used risk prediction tools in patients with Acute coronary syndrome (ACS). The present systematic review and meta-analysis aimed to compare the value of GRACE andHEART scores in the outcome prediction of ACS patient. Methods: The online databases of Medline, Embase, Web of Science, and Scopus were search until September 2022 for articles directly comparing GRACE and HEART scores value in prediction of outcome in patients with ACS. GRACE score cut-offs were categorized into two groups of less than and equal to 100 and more than 100, and HEART score cut-offs were categorized into three groups of less than 4, equal to 4, and more than 4. Investigated outcomes were major adverse cardiovascular events (MACE), acute myocardial infraction (AMI) and all-cause mortality. Results: 25 articles were included. The sensitivity and specificity of the GRACE score for prediction of MACE were 0. 96 and 0. 26 for cut-offs of ·,100, and 0. 58 and 0. 69 for cut-offs of >100, respectively. The sensitivity and specificity of the HEART score for prediction of MACE were 0. 99 and 0. 16 for cut-offs less than 4, 0. 93 and 0. 47 for equal to 4, and 0. 77 and 0. 78 for cut-offs greater than 4. GRACE score was shown to be predictive of AMI with sensitivity and specificity of 0. 95 and 0. 29, respectively. The analysis for the value of HEART score in the prediction of AMI a sensitivity and specificity of 0. 94 and 0. 48, respectively. The risk scores were not found to be suitable predictors of all-cause mortality. Conclusion: The results demonstrated the low specificity of GRACE and HEART scores in predicting the MACE, AMI and all-cause mortality, irrespective of the utilized cut-off. Considering the acceptable sensitivity of two scores in predicting theMACE and AMI, these scores were more suitable to be used as a rule-out tool for identification of ACS patients with low risk of developing adverse outcomes.

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APA: Copy

Kabiri, Ali, Gharin, Pantea, Forouzannia, Seyed Ali, Ahmadzadeh, Koohyar, MIRI, REZA, & YOUSEFIFARD, MAHMOUD. (2023). HEART versus GRACE Score in Predicting the Outcomes of Patients with Acute Coronary Syndrome, a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 11(1), 0-0. SID. https://sid.ir/paper/1115653/en

Vancouver: Copy

Kabiri Ali, Gharin Pantea, Forouzannia Seyed Ali, Ahmadzadeh Koohyar, MIRI REZA, YOUSEFIFARD MAHMOUD. HEART versus GRACE Score in Predicting the Outcomes of Patients with Acute Coronary Syndrome, a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2023;11(1):0-0. Available from: https://sid.ir/paper/1115653/en

IEEE: Copy

Ali Kabiri, Pantea Gharin, Seyed Ali Forouzannia, Koohyar Ahmadzadeh, REZA MIRI, and MAHMOUD YOUSEFIFARD, “HEART versus GRACE Score in Predicting the Outcomes of Patients with Acute Coronary Syndrome, a Systematic Review and Meta-Analysis,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 11, no. 1, pp. 0–0, 2023, [Online]. Available: https://sid.ir/paper/1115653/en

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