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. 2012 May-Jun;64(3):263-9.
doi: 10.1016/S0019-4832(12)60084-4.

Validation of the GRACE score for prognosis in Indian patients with acute coronary syndromes

Amar R Prabhudesai  1 , M A Srilakshmi, M J Santosh, Gurappa G Shetty, Kiron Varghese, Chandrakant B Patil, Shamanna S Iyengar
Affiliations

Validation of the GRACE score for prognosis in Indian patients with acute coronary syndromes

Amar R Prabhudesai et al. Indian Heart J. 2012 May-Jun.

Abstract

Aim: To validate the global registry of acute coronary events (GRACE) score in acute coronary syndromes (ACS) patients and study its angiographic correlation.

Methods and results: Two-hundred and thirty-five ACS patients were studied for the combined endpoint of all-cause in-hospital mortality and non-fatal infarction/reinfarction. We tested the predictive accuracy of the composite GRACE score using the receiver operating characteristics (ROC) curve. Lower systolic blood pressure (SBP) (odds ratio [OR] 7.93, P=0.005), ST-segment deviation (OR 7.79, P=0.02) and cardiac biomarker positivity (OR > 6.52, P=0.01) were significantly associated with events. Serum creatinine > 1.4 mg/dL showed a trend towards statistical significance (OR 4.14, P=0.05), whereas age > 50 years (OR 3.62, P=not significant [NS]) and Killips class 4 (OR 2.71, P=NS) showed good association. The best value for predicting events was a GRACE score of > 217 and these patients were more likely to have double/triple vessel disease (P = 0.0009). The C statistic for the GRACE score was 0.75.

Conclusion: Higher GRACE score predicts in-hospital events and more severe angiographic coronary artery disease (CAD).

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Figures

Figure 6
Figure 6
GRACE score correlation with angiographic findings. DVD: double vessel coronary artery disease, SVD: single vessel coronary artery disease, TVD: triple vessel coronary artery disease.
Figure 1
Figure 1
Patient distribution across the acute coronary syndrome spectrum. NSTEMI: non-ST-elevation myocardial infarction, STEMI: ST-elevation myocardial infarction, UA: unstable angina.
Figure 2
Figure 2
Event occurrence with increasing age.
Figure 3
Figure 3
Events according to Killips class.
Figure 4
Figure 4
Events in various quartiles of GRACE score.
Figure 5
Figure 5
Receiver operating characteristics (ROC) curve for GRACE score for predicting event.
See this image and copyright information in PMC

Comment in

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