Key result
GRACE 2.0 marginally outperforms EPICOR in predicting 1-year postdischarge mortality in ACS.
Why the study?
The study aimed to determine the performance of the GRACE 2.0 and EPICOR risk scores for predicting 1-year postdischarge mortality in Vietnamese patients with ACS.
Does the GRACE 2.0 risk score accurately predict 1-year postdischarge mortality compared to the EPICOR risk score in Vietnamese patients with ACS?
Cohort (n=455)
Yes
Does the GRACE 2.0 risk score accurately predict 1-year postdischarge mortality compared to the EPICOR risk score in Vietnamese patients with ACS?
The GRACE 2.0 risk score demonstrated better calibration than the EPICOR score for predicting 1-year postdischarge mortality in Vietnamese patients with ACS.
May favor GRACE 2.0 for 1-year mortality prediction in Vietnamese ACS; leaves open external validation in other Asian cohorts.
We aimed to determine the performance of the Global Registry of Acute Coronary Events (GRACE) risk score version 2.0, and the long-term follow up of antithrombotic management patterns in acute coronary syndrome patients (EPICOR) risk score for predicting 1-year postdischarge mortality in patients with acute coronary syndrome (ACS) in Vietnam. A prospective cohort study was conducted on 455 patients who were discharged with an ACS diagnosis from two hospitals in Can Tho, and one in Ho Chi Minh City. Online simplified EPICOR and GRACE 2.0 calculators were used to assess the expected risk of death. We compared the performance of predicting 1-year mortality between GRACE 2.0 and EPICOR risk scores by using the Hosmer-Lemeshow test, the area under the curve (AUC), and the De-Long test. The proportions of low-risk group, moderate-risk group, and high-risk group for GRACE were 31%, 42%, and 27%, respectively. Actual mortality rates for the low, medium and high-risk groups were 3.6%, 9.4%, and 19.4%. The proportions of low-risk and high-risk patients for EPICOR were 92.0% and 8.0%, respectively. The actual mortality rate of the high-risk group was 31.4%, and of the low-risk group 8.6%. Hosmer-Lemeshow test results of the GRACE 2.0 and EPICOR were 0.337 and 0.001, respectively. The AUC results of the GRACE 2.0 and EPICOR were 0.703 and 0.752 respectively, and the De-Long test with p = 0.0532. In conclusion, the GRACE 2.0 was better than EPICOR in predicting 1-year postdischarge mortality in Vietnamese patients with ACS. None to declare.
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Nguyen et al. (2021) conducted a cohort in acute coronary syndrome (n=455). GRACE 2.0 risk score vs. EPICOR risk score was evaluated on 1-year postdischarge mortality (AUC 0.703 vs 0.752, p=0.0532). The GRACE 2.0 risk score was better than EPICOR in predicting 1-year postdischarge mortality in Vietnamese patients with acute coronary syndrome (AUC 0.703 vs 0.752; p=0.0532).
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