Inteligência artificial na estratificação de risco da síndrome coronariana aguda: uma revisão comparativa com escores clínicos tradicionais

Acute Coronary Syndrome (ACS) demands early and effective risk stratification to guide rapid clinical decisions in emergency settings. Given the limitations of traditional scores in capturing complex non-linear biological interactions, this study aimed to review the discriminatory and predictive performance of Artificial Intelligence (AI) models, such as Machine Learning and Deep Learning, compared to conventional tools (GRACE, TIMI, and HEART) in predicting Major Adverse Cardiovascular Events (MACE). For this purpose, an integrative literature review was conducted based on the PRISMA 2020 protocol, selecting nine original articles published in PubMed between 2021 and 2026. The results consistently demonstrate that AI algorithms outperform the accuracy of current clinical scores, achieving Areas Under the ROC Curve (AUROC) of up to 0.94. This prognostic refinement is rooted in the autonomous extraction of subtle morphological variables from raw electrocardiograms — drastically reducing false positives in the cath lab — and the synergistic integration of molecular and inflammatory biomarkers. Explainable tools such as SHAP validate mathematical findings by aligning them with medical guidelines. In conclusion, AI represents a disruptive advancement in ACS risk stratification. However, definitive bedside translation still depends on overcoming methodological challenges, requiring external validations with real-time live data streams to establish a safe and personalized clinical practice.