What is the clinical evidence from this study?

Study design: Observational. Population: Non-ST elevation acute coronary syndrome (n=300). Intervention: GRACE score ≥ 120 vs. GRACE score < 120. Primary outcome: In-hospital mortality (AOR 22.905, 95% CI 2.744-191.172, p=0.001).

March 6, 2021The Egyptian Heart Journal21 citationsOpen Access

Prognostic value of GRACE score for in-hospital and 6 months outcomes after non-ST elevation acute coronary syndrome

Q: What are the key findings of this study?

A GRACE score of 120 or higher was significantly associated with increased in-hospital mortality (AOR 22.905) in patients with non-ST elevation acute coronary syndrome.

DKDileep Kumar AAArti Ashok TSTahir Saghir

Key Result

A GRACE score of 120 or higher was significantly associated with increased in-hospital mortality (AOR 22.905) in patients with non-ST elevation acute coronary syndrome.

Study Design

Type

Observational (n=300)

Multicenter

Structured PICO

Population

300 patients aged 32 to 95 years with non-ST elevation acute coronary syndrome, followed for 6 months to assess the predictive value of the GRACE score for mortality.

Exposure

GRACE score risk stratification

Outcome

In-hospital mortality and 6-month mortalityhard clinical

The GRACE score is a strong independent predictor of in-hospital and 6-month mortality in patients with NSTE-ACS, confirming its utility for risk stratification.

Main Result

Odds Ratio: 22.905 (95% CI 2.744–191.172)

p-value: p=0.001

Limitations

Single-center study based on a smaller sample size
Findings lack generalizability for non-tertiary care hospitals and distinct communities
Does not inherently accurately estimate the risk of individual person
single-center study
smaller sample size
does not inherently accurately estimate the risk of individual person

Abstract

BACKGROUND: The aim of this study was to determine the predictive value of the Global Registry of Acute Coronary Events (GRACE) score for predicting in-hospital and 6 months mortality after non-ST elevation acute coronary syndrome (NSTE-ACS). RESULTS: In this observational study, 300 patients with NSTE-ACS of age more than 30 years were included; 16 patients died during the hospital stay (5.3%). Of 284 patients at 6 months assessment, 10 patients died (3.5%), 240 survived (84.5%), and 34 were lost to follow-up (12%) respectively. In high risk category, 10.5% of the patients died within hospital stay and 11.8% died within 6 months (p = 0.001 and p = 0.013). In univariate analysis, gender, diabetes mellitus, family history, smoking, and GRACE score were significantly associated with in-hospital mortality whereas age, obesity, dyslipidemia, and GRACE were significantly associated with 6 months mortality. After adjustment, diabetes mellitus, family history, and GRACE score remained significantly associated with in-hospital mortality (p ≤ 0.05) and age remained significantly associated with 6 months mortality. CONCLUSION: GRACE risk score has good predictive value for the prediction of in-hospital mortality and 6 months mortality among patients with NSTE-ACS.

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