Validation of the Grace Risk Score to Predict In-Hospital and 6-Month Post-Discharge Mortality in Patients with Acute Coronary Syndrome

Abstract

Cardiovascular disease is the leading cause of mortality in Brazil and worldwide, and ischemic heart disease accounts for a large portion of this concerning scenario. 1 Among its forms of presentation, acute coronary syndrome (ACS) has a wide range of severity. 2 However, the use of validated mathematical models of clinical prediction is essential and recommended in national and international guidelines for the management of patients with ACS. 3,4 With this stratification, high-risk patients may receive more aggressive antiplatelet and antithrombotic therapy and early invasive intervention, whereas lower-risk patients may receive less aggressive treatments. 3,5 Based on the Global Registry of Acute Coronary Events (GRACE) report, the GRACE score was designed with 8 variables analyzed on patient's admission, 6 5 semiquantitative ones (age range, heart rate, systolic blood pressure, plasma creatinine, and Killip class) and 3

Risk Scores in Acute Coronary Syndrome: Current Applications and Future Perspectives

“…Pedro G. M. de Barros e Silva, 1,2,3 Renato D. Lopes 1,2,4 Brazilian Clinical Research Institute, 1 São Paulo, SP -Brazil Hospital Samaritano Paulista, 2 São Paulo, SP -Brazil Centro Universitário São Camilo, 3…”

“…and wide confidence intervals, the consistency of good discrimination and calibration of this score in different populations reinforces this model as an appropriate tool to estimate the risk of patients with ACS. 2,3 Once a model has shown good performance in estimating risk, it is important to determine if this information may change the clinical practice. Patients with STEMI usually receive a standard level of care and changes in the approach are made more due to complications (e.g.…”