Skor Heart dan Grace sebagai Metode Diagnosis dan Stratifikasi Risiko Pasien Sindrom Koroner Akut di RS Adam Malik

Abstract

Objective: To evaluate whether the HEART and GRACE scores have good capabilities as a method for diagnosing a myocardial infarction and risk stratification in predicting in-hospital Major Adverse Cardiovascular Events (MACE) in Acute Coronary Syndrome (ACS) patients at H Adam Malik Hospital. Method: This research is a retrospective and prospective observational study. Retrospective data was collected from all medical records of ACS patients at Adam Malik Hospital from January to December 2022. Prospective data was collected by consecutive sampling until the minimum sample size was met in October 2023. Samples included in the research analysis were those who met the inclusion criteria without the exclusion criteria. Results: As a diagnostic method, the HEART score is superior to the GRACE score with an AUC of 0.903, a cutoff of 6.5, sensitivity of 86%, and specificity of 80%. As a risk stratification, the GRACE score is superior to the HEART score with an AUC of 0.719, a cutoff of 128.5, a sensitivity of 66%, and a specificity of 65%. The total number of samples was 353. There were 266 (75.35%) men and 87 (24.65%) women. The youngest patient was 30 years old, and the oldest was 85 years old, with a mean age of 58 years. The average heart rate was 78 x/minute, systolic blood pressure was 134 mmHg, most had < 3 cardiac risk factors, and ECG’s changes were found. From this research, we also designed a new scoring system as a diagnosis and risk stratification method without including the laboratory results. Conclusion: The HEART score is superior to the GRACE score in diagnosing a myocardial infarction. The GRACE score is superior to the HEART score in predicting in-hospital major adverse cardiovascular events.