Global Registry of Acute Coronary Event (GRACE) Risk Score as a Predictor of In-hospital Mortality for Acute Coronary Syndrome in Trinidad and Tobago

2015 ◽  
Author(s):  
M Chin ◽  
T Cummings ◽  
C Thomas ◽  
T Seemungal
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Trinidad And Tobago ◽  
Risk Score ◽  
Coronary Event ◽  
Acute Coronary Event ◽  
Coronary Syndrome ◽  
Grace Risk Score ◽  
Global Registry

scholarly journals GRACE risk score: Sex-based validity of in-hospital mortality prediction in Canadian patients with acute coronary syndrome

2017 ◽  
Vol 244 ◽  
pp. 24-29 ◽  
Author(s):  
Inna Y. Gong ◽  
Shaun G. Goodman ◽  
David Brieger ◽  
Chris P. Gale ◽  
Derek P. Chew ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Risk Score ◽  
Mortality Prediction ◽  
Coronary Syndrome ◽  
Grace Risk Score

scholarly journals Clinical Application of Grace Risk Score in Patients with Acute Coronary Syndrome

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Samar Firdous ◽  
Uzma Malik
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Clinical Application ◽  
Risk Score ◽  
Adverse Outcomes ◽  
Cardiac Biomarkers ◽  
Hospital Death ◽  
Coronary Syndrome ◽  
Grace Risk Score ◽  
The Mean

Objectives:  To determine clinical application of GRACE risk score in patients with acute coronary syndrome (ACS).Patients and Methods:  It was an observational analytical study conducted in the Cardiology ward of Mayo hospital, Lahore from April to July 2015. Patients with Acute STEMI, NSTEMI or Unstable angina (UA) were selected on the basis of typical chest pain, ECG changes or cardiac biomarkers .For all eligible cases, at presentation GRS was calculated using online calculator. Also, GRACE risk categories and predicted in-hospital mortality were determined. Patients with previous episodes of STEMI/ NSTEMI, old Left Bundle Branch Block (LBBB), stable angina pectoris, acute pericarditis, myocarditis, acute rheumatic fever or pulmonary embolism were excluded. Data was analyzed on SPSS 20 and the R project for statistical computing. Individual components of GRS were compared among discharged and expired cases using t-test. A p-value of <0.05 was considered significant.Results:  A total of 165 patients with STEMI and ACS were included. The mean GRS among males andfemales was 137.4 ± 39 and 151.5 ± 50.6. The observed in-hospital mortality was 12.12% with 60% patients of STEMI. Among expired cases, 90% patients had high GRS, predominantly from STEMI group. Important determinants of adverse outcome were advanced age, tachycardia, low systolic blood pressure and presence of cardiac failure.Conclusion:  STEMI was the major acute cardiac event. The mean GRS of expired patients was significantly higher than discharged group. GRS accurately identified low risk cases with low probability of in-hospital death. GRS over estimate probability of in-hospital death among STEMI high risk cases that had higher scores and discharged uneventfully. Grace Risk Score is a reliable predictor of risk category and adverse outcomes and its use by clinicians should be strongly recommended.

scholarly journals Impact of Admission Blood Glucose Added on GRACE Risk Score for All-Cause In-Hospital Mortality in Patients with Acute Coronary Syndrome

2018 ◽  
Vol 33 (2) ◽  
pp. 94-99
Author(s):  
Md Mesbahul Islam ◽  
Mohsin Ahmed ◽  
Mohammad Ali ◽  
Abdul Wadud Chowdhury ◽  
Khandakar Abu Rubayat
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Glucose ◽  
Hospital Mortality ◽  
Blood Sugar ◽  
Risk Score ◽  
Hospital Death ◽  
Predictive Values ◽  
Coronary Syndrome ◽  
Grace Risk Score ◽  
Grace Score

Background: Abnormal glucose metabolism is a predictor of worse outcome after acute coronary syndrome (ACS). However, this parameter is not included in risk prediction scores, including GRACE risk score. We sought to evaluate whether the inclusion of blood glucose at admission in a model with GRACE risk score improves risk stratification. Objectives: To assess whether inclusion of admission blood glucose in a model with GRACE risk score improves risk stratification of ACS patients admitted in a tertiary hospital of Bangladesh. Methods: This cross sectional comparative study was carried out in the department of cardiology, Dhaka Medical College Hospital (DMCH), Dhaka between May 2016 to April 2017. Data were collected from ACS patients admitted at CCU, DMCH who fulfilled inclusion and exclusion criteria. GRACE score was calculated for each patient. The predictive value of death by GRACE score was compared with the predictive value of combined GRACE score + admission blood sugar. Comparison between these results in two groups were done by unpaired t-test, analysis was conducted SPSS-22.0 for windows software. The significance of the results was determined in 95.0% confidence interval and a value of p <0.05 was considered to be statistically significant. Results: A total of 249 cases of ACS patients were selected. Most of the patients belonged to 5th and 6th decades 25.3% vs 37.3% and the mean age was 55.7±11.7 years. Most of the patients were male. High GRACE risk score (≥155) and elevated admission blood sugar (≥11) was found significantly higher in-hospital death whereas only high GRACE risk score (≥155) and normal admission blood sugar (<11) was found non significant regarding in-hospital death. Test of validity showed sensitivity of GRACE risk score regarding in-hospital death was 85.29%, specificity 57.7%, accuracy 61.4%, positive and negative predictive values were 24.2% and 96.1% respectively. The sensitivity of GRACE risk score + admission blood sugar regarding in-hospital death was 85.29%, specificity 62.33%, accuracy 65.46%, positive and negative predictive values were 26.36% and 96.4% respectively. Receiver-operator characteristic (ROC) were constructed using GRACE score and GRACE score + admission blood sugar of the patients with in-hospital death, which showed the sensitivity and specificity of GRACE score for predicting in-hospital death were found to be 79.4% and 58.1%, respectively. Whereas after adding admission blood sugar value to GRACE score both the sensitivity and specificity increased to 82.4% and 58.6% respectively in this new model. Logistic regression analysis of in-hospital mortality with independent risk factors showed GRACE score (≥155) + admission blood sugar (≥11.0 mmol/l) was more significantly associated with in-hospital mortality (P =0.001, OR = 6.675, 95% CI 2.366-13.610). Conclusion: In patients with the whole spectrum of acute coronary syndrome admission blood glucose can add prognostic information to the established risk factors with the GRACE risk score. Bangladesh Heart Journal 2018; 33(2) : 94-99

scholarly journals The new classification method in ACEF score is more useful in patients with acute coronary syndrome without ST segment elevation

Kardiologiia ◽  
2021 ◽  
Vol 61 (2) ◽  
pp. 83-90
Author(s):  
Saadet Demirtas Inci ◽  
Mustafa Agah Tekindal
Keyword(s):  
Acute Coronary Syndrome ◽  
Ejection Fraction ◽  
Hospital Mortality ◽  
Risk Score ◽  
Primary Outcome ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Coronary Syndrome ◽  
Grace Risk Score ◽  
All Cause Mortality

Goal In this study, it was investigated whether the age, creatinine, and ejection fraction (ACEF) score [age (years) / ejection fraction (%) +1 (if creatinine >2 mg / dL)] could predict in-hospital mortality in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods The study enrolled 658 NSTE-ACS patients from January 2016 to August 2020. The patients were divided into two groups according to the ACEF score with an optimum cut-off value of 1.283 who were divided into two groups according to the ACEF score: low ACEF (≤1.283, n:382) and high ACEF (>1.283, n: 276). The primary outcome of the study was in-hospital all-cause mortality. The primary outcome of the study was in-hospital all-cause mortality. Statistically accuracy was defined with area under the curve by receiver-operating characteristic curve analysis.Results In total, 13 (4.71 %) patients had in-hospital mortality. The ACEF score was significantly higher in the group with higher mortality than in the group with low mortality (2.1±0.53 vs. 1.34±0.56 p=0.001). The ACEF score was positively correlated with GRACE risk score (r=0.188 p<0.0001). In ROC curve analysis, the AUC of the ACEF score for predicting in-hospital mortality was 0.849 (95 % CI, 0.820 to 0.876; p<0.0001); sensitivity, 92.3 %; specificity, 59.2 %, and the optimum cut-off value was >1.283.Conclusion The ACEF score presented excellent discrimination in predicting in-hospital mortality. We obtained an easier and more useful result by dividing the ACEF score into two groups instead of three in NSTE-ACS patients. As a simple, useful, and easily applicable risk stratification in the evaluation of an emergency event such as the ACEF score, it can significantly contribute to the identification of patients at high risk.

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