Demographics of Acute Coronary Syndrome (ACS) Egyptian patients admitted to Assiut University Hospital: Validation of TIMI and GRACE scores

Aims: This prospective cross-sectional observational study aimed at reporting the demographics of ACS patients admitted to Assiut University Hospital, Egypt, and validating both TIMI (Thrombolysis in Myocardial Infarction) and GRACE (Global Registry of Acute Coronary Events) scores in the prediction of both in-hospital MACE and 30-day mortality and recurrent MI in both ST-elevation myocardial infarction (STEMI) and unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) patients. Methods: Data were collected from all admitted patients over one year from April 1, 2011. Results: The study included 795 patients, 270 (34%) with STEMI and 525 (66%) with UA/ NSTEMI with a comparable mean age (58 +/- 11 vs 57 +/- 12 years, respectively). The STEMI patients had higher rates of male gender (75% vs 64%), smoking (51% vs 38%), and familial predisposition (16% vs 7%). The UA/ NSTEMI patients had higher rates of a history of previous ischemia (70% vs 24%), hypertension (59% vs 33%), and diabetes (45% vs 34%). STEMI was associated with a higher in-hospital MACE (23.3% vs 13.7%) and a higher 30-day all-cause mortality rate (9% vs 2%) and recurrent non-fatal MI (35% vs 15%). Conclusion: ACS occurs at a relatively young age in our locality, in patients sharing common known coronary risk factors. STEMI patients, in our locality, represent approximately one-third of ACS patients and are associated with worse in-hospital as well as 30-day outcomes. Both TIMI and GRACE risk scores are valid for use in ACS patients in the Assiut governorate (c-statistics 0.72-0.97), with a better discriminative ability for the GRACE score, especially in UA/STEMI patients.(C) 2014 The Egyptian College of Critical Care Physicians.