ArticleInternational journal of emergency medicine2026
Application of HEART, GRACE 2.0 and TIMI scores for risk stratification of chest pain: a single-centre external pilot study in a Sri Lankan population.
Article in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHEART score is widely used for risk stratification in patients with chest pain. TIMI and GRACE 2.0 scores are recommended for prognostication in patients with acute coronary syndrome (ACS). This study aimed to explore feasibility of conducting a larger study to evaluate the effectiveness of HEART score in a Sri Lankan population for risk stratification in patients presenting with chest pain, and to compare its diagnostic accuracy with GRACE 2.0 and TIMI scores.
methodsData were collected from 74 patients presenting with chest pain. HEART, GRACE 2.0 and TIMI scores were calculated for each patient. The predictive accuracy of the HEART score for diagnosing ACS and the predicting the occurrence of major adverse cardiac events (MACE) within 6 weeks was assessed and compared with TIMI and GRACE 2.0. scores.
resultsThe area under receiver operating characteristic curve (AUC-ROC) for the HEART, GRACE 2.0 and TIMI scores, for the diagnosis of ACS, were 0.889 (95% CI: 0.8171–0.9609), 0.805 (95% CI: 0.6758–0.9349), 0.812 (95% CI: 0.6961–0.9278) respectively, without any statistically significant pairwise difference between the scores. For prediction of MACE, the AUC-ROC values were 0.905 (95% CI: 0.8437–0.9669), 0.721 (95% CI: 0.5934–0.8493), and 0.767 (95% CI: 0.6467–0.888) for the HEART, GRACE 2.0 and TIMI scores respectively, with statistically significant differences observed between the scores.
conclusionsExploratory evidence from this pilot study suggests that the HEART score demonstrates good diagnostic accuracy for ACS and short-term risk of MACE in this cohort. Its diagnostic accuracy for ACS appears comparable to GRACE 2.0 and TIMI scores while demonstrating superior predictive accuracy for MACE. However, given the small sample size and high event rate, these findings should be interpreted with caution and require validation in larger studies.
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