Title : A longitudinal study of killip, Thrombolysis In Myocardial Infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), risk scores for prediction of long term cardio vascular outcomes in patients presenting with acute st elevation myocardial infarction in a tertiary care centre
Abstract:
Background :Ischaemic heart disease is the leading cause of death in india .ST elevation myocardial infarction ( STEMI) incidence is 1.1 per million i.e 1.34 million STEMI every year. The Score like KILLIP, TIMI, GRACE are used to assesthe mortality among patients with acute ST Elevation myocardial infarction. The diagnostic accuracy of mortality among these scores are need of the hour. This study was done to estimate the level of risk score with that of mortality.
Methods :A Longitudinal study was conducted among 561 Acute ST Elevation myocardial infarction patients admitted in Cardiac ICCU of Chengalpattu Medical College & Hospital between April 2022 to April 2023. All the patients underwent lysis within the window period where assessed its risk score KILLIP, TIMI, GRACE with the mortality respectively.
Results :Mean age of patients in this study was 56.93 + 11.87 Years,Majority were Male - 74.87% and AWMI Present in 58.11 %, IWMI Present in 41.89%. Mean Score of KILLIP, TIMI, GRACE were 1.79+ 1.07, 4.68 + 3.06, 147.74 +35.84 respectively. Sensitivity of KILLIP, TIMI, GRACE were 86.57%, 80.60%, 83.58% respectively. Specificity of KILLIP, TIMI, GRACE were 85.02%, 74.09%, 81.98% respectively Area Under the Curve (AUC) of KILLIP, TIMI, GRACE were 0.85 (95% CI 0.80-0.91), 0.82 (95% CI 0.78-0.87), 0.86 (95% CI 0.81-0.90)respectively. Diagnostic accuracy of KILLIP >2, TIMI >5, GRACE >167 were 86.57%, 80.60%, 83.58% respectively. Case Fatality rate among the study population was 11.94%
Conclusion: In Our population Killip,Grace showed better predictive accuracy than Timi.Increased mortality were observed with higher risk score.Therefore the prognostic KILLIP GRACE TIMI score are robust tool in redicting mortality
