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ANALYSIS OF COMPARISON OF THE GRACE, HEART AND TIMI SCORE TO PREDICT MAJOR ADVERSE CARDIAC EVENTS IN CHEST PAIN PATIENTS IN PAKISTAN

Dr Zaryab Jamil, Dr Izam Afzal, Dr Zartasha Riasat

Introduction: Chest pain is a common presenting symptom in the emergency department (ED). Numerous chest pain patients are admitted to the medical clinic because of the likelihood of dangerous conditions, for example, intense myocardial dead tissue (AMI). Aims and objectives: The basic aim of the study is to compare the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients in Pakistan. Methodology of the study: This study was conducted in Benazir Bhutto Hospital, Rawalpindi during September to November 2018. The data was collected from the emergency department of the hospital. We collected the data of those patients who visit the emergency department of hospital for the chest pain. Any patient with chest pain presenting to the ED was eligible for inclusion. Patients specifically perceived as having ST-rise myocardial localized necrosis (STEMI) were rejected, as a result of the absence of indicative vulnerability. Every single included patient gave composed educated assent. The GRACE score and TIMI score were determined naturally from the tentatively gathered information, without translation by the agents. Results: The data were collected from 100 patients of both genders. The mean age of selected population is 62 years. Comparison of performance of GRACE, HEART and TIMI score in terms of safety and efficiency. This is an absolute level of safety of missing no > 5% of all patients with MACE to define a “low-risk” group. At this absolute safety level, the GRACE score classified 334 patients as “low risk” of whom 12/334 (3.6%) patients developed MACE. Using the same absolute safety level, the HEART score classified 708 patients as “low risk” with 14/708 (2.0%) patients developing MACE. Conclusion: It is concluded that chest pain, as a common yet potentially life-threatening condition, deserves much attention in risk stratification and management, particularly in the ED where quick decisions are required for efficient patient care. The HEART score performed best in discriminating between those with and without MACE. Key words: Cardiac, Chest, Pain, GRACE, TIMI, Score.

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