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Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome.
Am Heart J. 2007 Jan; 153(1):29-35.AH

Abstract

BACKGROUND

The Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score (GRACE score) developed from a multinational registry involving all subsets of acute coronary syndrome (ACS) predicted 6-month survival. There is currently no validated risk model to predict mortality beyond 6 months.

METHODS AND RESULTS

Of the 1143 consecutive patients with ACS admitted to coronary care unit in 2000 to 2002 (mean age, 64.9 +/- 12.6 years), 39% had ST-elevation myocardial infarction, 39% had non-ST-elevation infarction, and 22% had unstable angina. The mortality was 7.5% during index admission, 12.1% at 6 months, 14.8% at 1 year, 18.7% at 2 years, 25.0% at 3 years, and 39.2% at 4 years. The GRACE hospital discharge risk score calculated for 1057 hospital survivors discriminated survival from death at 6 months (C index, 0.81), 1 year (C index, 0.82), 2 years (C index, 0.81), 3 years (C index, 0.81), and 4 years (C index, 0.80). The risk score worked for all 3 subsets of ACS at all time points, with C index >0.75 in all analyses. A separate multivariable mortality model for these 1057 patients over the 4-years follow-up period identified 10 independent predictors of mortality. Seven were in the GRACE risk model (age, history of ischemic heart disease, heart failure, increased heart rate on admission, serum creatinine level, evidence of myonecrosis, not receiving in-hospital percutaneous coronary intervention).

CONCLUSIONS

The GRACE postdischarge risk score contains relevant prognostic factors and accurately discriminate survivors from nonsurvivors over the longer term (up to 4 years) in all subsets of ACS patients.

Authors+Show Affiliations

Cardiology Division, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17174633

Citation

Tang, Eng Wei, et al. "Global Registry of Acute Coronary Events (GRACE) Hospital Discharge Risk Score Accurately Predicts Long-term Mortality Post Acute Coronary Syndrome." American Heart Journal, vol. 153, no. 1, 2007, pp. 29-35.
Tang EW, Wong CK, Herbison P. Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. Am Heart J. 2007;153(1):29-35.
Tang, E. W., Wong, C. K., & Herbison, P. (2007). Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. American Heart Journal, 153(1), 29-35.
Tang EW, Wong CK, Herbison P. Global Registry of Acute Coronary Events (GRACE) Hospital Discharge Risk Score Accurately Predicts Long-term Mortality Post Acute Coronary Syndrome. Am Heart J. 2007;153(1):29-35. PubMed PMID: 17174633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. AU - Tang,Eng Wei, AU - Wong,Cheuk-Kit, AU - Herbison,Peter, PY - 2006/05/16/received PY - 2006/10/09/accepted PY - 2006/12/19/pubmed PY - 2007/1/26/medline PY - 2006/12/19/entrez SP - 29 EP - 35 JF - American heart journal JO - Am Heart J VL - 153 IS - 1 N2 - BACKGROUND: The Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score (GRACE score) developed from a multinational registry involving all subsets of acute coronary syndrome (ACS) predicted 6-month survival. There is currently no validated risk model to predict mortality beyond 6 months. METHODS AND RESULTS: Of the 1143 consecutive patients with ACS admitted to coronary care unit in 2000 to 2002 (mean age, 64.9 +/- 12.6 years), 39% had ST-elevation myocardial infarction, 39% had non-ST-elevation infarction, and 22% had unstable angina. The mortality was 7.5% during index admission, 12.1% at 6 months, 14.8% at 1 year, 18.7% at 2 years, 25.0% at 3 years, and 39.2% at 4 years. The GRACE hospital discharge risk score calculated for 1057 hospital survivors discriminated survival from death at 6 months (C index, 0.81), 1 year (C index, 0.82), 2 years (C index, 0.81), 3 years (C index, 0.81), and 4 years (C index, 0.80). The risk score worked for all 3 subsets of ACS at all time points, with C index >0.75 in all analyses. A separate multivariable mortality model for these 1057 patients over the 4-years follow-up period identified 10 independent predictors of mortality. Seven were in the GRACE risk model (age, history of ischemic heart disease, heart failure, increased heart rate on admission, serum creatinine level, evidence of myonecrosis, not receiving in-hospital percutaneous coronary intervention). CONCLUSIONS: The GRACE postdischarge risk score contains relevant prognostic factors and accurately discriminate survivors from nonsurvivors over the longer term (up to 4 years) in all subsets of ACS patients. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/17174633/Global_Registry_of_Acute_Coronary_Events__GRACE__hospital_discharge_risk_score_accurately_predicts_long_term_mortality_post_acute_coronary_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(06)00896-9 DB - PRIME DP - Unbound Medicine ER -