Predictability of adverse clinical events following ST-elevation myocardial infarction by risk assessment tools

Background: Killip classes, TIMI and GRACE scores are simple validated clinical risk scores used in risk stratification in acute coronary syndrome including ST-elevation myocardial infarction (STEMI). Objectives: Our study aimed to determine the predictive ability of post-myocardial adverse events by commonly used clinical risk scores. Materials and Methods: Data were analysed from 120 male patients with acute STEMI, admitted to Teaching Hospital, Karapitiya. The risk scores were calculated during the acute phase. Patients were followed up for 365 days for the occurrence of clinically significant adverse cardiovascular events. Results: Adverse clinical events related to STEMI developed in 50(41.7%) patients during the hospital stay. Later, during the follow up of 365 days, 39 (32.5%) patients developed major complications. Killip class II-IV was significantly (p = 0.001) associated with adverse clinical events during the hospital stay, but not later. TIMI score was a significant predictor of the occurrence of the clinically significant STEMI related adverse events, while in the ward (p = 0.004, OR = 1.51) and during the first 30 days (p = 0.008, OR = 1.42), but not beyond this period. GRACE score was unable to predict the adverse cardiovascular events in this patient cohort. Negative predictive values for both TIMI and GRACE scores were close to 100 at each time interval. Conclusions: The development of major complications or adverse clinical events following STEMI was less common in the cohort. The TIMI score could predict the adverse events until 30 days, but not later. GRACE score was unable to predict adverse events. Killip class grading was strongly associated with the major complications occurred during the hospital stay.