Scoring systems in patients with acute coronary syndrome

Authors: E. Ganovská 1;  S. Littnerová 2;  J. Špinar 1,3;  J. Pařenica 1,3
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno 1;  Institut bio­statistiky a analýz, LF a PřF MU, Brno 2;  Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně 3
Published in: Kardiol Rev Int Med 2015, 17(2): 117-120
Category: Cardiology Review


Patients with acute coronary syndrome (ACS) are a heterogeneous group of patients with various risks for early and late complications. Early stratification of patients with ACS is a key for selection of optimal therapeutic strategies. For the risk stratification of patients in clinical practice we use a number of scoring systems. The main aim of the article was to predict the prognosis and mortality of patients with ACS. The article presents the most commonly used scoring systems –  TIMI, PURSUIT, GRACE and ZWOLLE score.



1. Kolh P, Windecker S. ESC/ EACTS myocardial revascularization guidelines 2014. Eur Heart J2014; 35: 3235– 3236. doi: 10.1093/ eurheartj/ ehu422.

2. Fox KA, Dabbous OH, Goldberg RJ et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coro­nary syndrome: prospective multinational observational study (GRACE). BMJ 2006; 333: 1091. doi: 10.1136/ bmj.38985.646481.55.

3. de Araújo Gonçalves P, Ferreira J, Aguiar C et al. TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE- ACS. Eur Heart J 2005; 26: 865– 872. doi: 10.1093/ eurheartj/ ehi187.

4. Morrow DA, Antman EM, Charlesworth A et al. TIMI risk score for ST‑Elevation myocardial infarction: a convenient, bedside, clinicals score for risk assessment at presentation an intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 2000; 102: 2031– 2037. doi: 10.1161/ 01.CIR.102.17.2031

5. Than MP, Flaws DF, Cullen L et al. Cardiac risk stratification scoring systems for suspected acute coronary syndromes in the emergency department. Curr Emerg Hosp Med Rep 2013; 1: 53– 63. doi: 10.1007/ s40138- 012- 0004- 0.

6. Backus BE, Six AJ, Kelder JH et al. Risk scores for patients with chest pain: evaluation in the emergency department. Curr Cardiol Rev 2011; 7: 2– 8. doi: 10.2174/ 157340311795677662.

7. Abbasnezhad M, Soleimanpour H, Sasaie M et al. Comparison of prediction between TIMI (thrombolysis in myocardial infarction) risk score and modified TIMI risk score in discharged patients from emergency department with atypical chest pain. Iran Red Crescent Med J 2014; 16: e13938. doi: 10.5812/ ircmj.13938.

8. Antman EM, Cohen M, Bernink PJ et al. The TIMI risk score for unstable angina/ non‑ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 2000; 284: 835– 842. doi: 10.1001/ jama.284.7.835.

9. Morrow DA, Antman EM, Parsons L et al. Application of the TIMI risk score for ST‑elevation MI in the National Registry of Myocardial Infarction. JAMA 2001; 286: 1356– 1359. doi: 10.1001/ jama.286.11.1356.

10. Lev EI, Kornowski R, Vaknin‑Assa H et al. Comparison of the predictive value of four different risk scores for outcomes of patients with ST‑elevation acute myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 2008; 102: 6– 11. doi: 10.1016/ j.amjcard.2008.02.088.

11. Backus BE, Six AJ, Kelder JH et al. Risk scores for patients with chest pain: evaluation in the emergency department. Curr Cardiol Rev 2011; 7: 2– 8. doi: 10.2174/ 157340311795677662.

12. Shaikh MK, Hanif B, Shaikh K et al. Validation of Grace Risk Score in predicting in‑hospital mortality in patients with non ST‑elevation myocardial infarction and unstable angina. J Pak Med Assoc 2014; 64: 807– 811.

13. McAllister D, Halbesma N, Carruthers K et al. GRACE score predicts heart failure admission fol­lowing acute coronary syndrome. Eur Heart J Acute Cardiovascular Care 2015; 4: 165– 171. doi: 10.1177/ 2048872614542724.

14. Widera C, Pencina MJ, Meisner A et al. Adjust­ment of the GRACE score by growth differentiation factor 15 enables a more accurate appreciation of risk in non‑ST‑elevation acute coronary syndrome. Eur Heart J 2012; 33: 1095– 1104. doi: 10.1093/ eurheartj/ ehr444.

15. Dirk AM, Schellings DA, Adiyaman A et al. Early discharge after primary percutaneous coronary intervention: the added value of N‑terminal pro‑brain natriuretic peptide to the Zwolle Risk Score. J Am Heart Assoc 2014; 3: e001089. doi: 10.1161/ JAHA.114.001089.

16. Kotowycz MA, Cosman TL, Tartaglia C et al. Safety and feasibility of early hospital discharge in ST‑segment elevation myocardial infarction –  a prospective and randomized trial in low- risk primary percutaneous coronary intervention patients (the Safe- Depart Trial). Am Heart J 2010; 159: 117.e6. doi: 10.1016/ j.ahj.2009.10.024.

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