GRACE_ACS v.1

GRACE [Global Registry of Acute Coronary Events] acute coronary syndrome (ACS) risk: Estimates admission-6-month mortality for patients with ACS

Syeeda S Farruque

models@cambiocds.com

© Cambio Healthcare Systems

Identified patients will have a known STEMI (ST Elevation Myocardial Infarction) or NSTEMI (Non-ST Elevation Myocardial Infarction).

Determining the mortality of these patients can be achieved with these 8 variables: Age in years Heart Rate Systolic Blood Pressure Creatinine (mg/dL) Cardiac arrest at admission ST segment deviation on EKG Elevated/abnormal cardiac enzymes Killip class (signs/symptoms): No CHF - Class I Rales and/or JVD - Class II Pulmonary edema - Class III Cardiogenic shock - Class IV The sum total of all the individual scores ranges from 0 to 372 with discretized buckets to score for continuous variables such as Age and Heart rate for example. The full details can be seen on (1) with details on scoring and more scoring interpretations beyond that below, in (2). Score interpretations: Non-STE ACS in-hospital mortality: Low: score 1-108 (<1% probablility of death in hospital) Intermediate: score 109-140 (1-3%) High: score 141-372 (>3%)

The score was not designed to assess which patients’ anginal symptoms are due to ACS and should not be used out of context without a more thorough clinical examination.

Ref. 1: Fox KA, Dabbous OH, Goldberg RJ, Pieper KS, Eagle KA, Van de Werf F, Avezum A,Goodman SG, Flather MD, Anderson FA Jr, Granger CB. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006 Nov 25;333(7578):1091. Epub 2006 Oct 10. PubMed PMID: 17032691; PubMed Central PMCID: PMC1661748. Ref. 2: http://www.outcomes-umassmed.org/GRACE/grace_risk_table.aspx ; University Court of the University of Edinburgh and the University of Massachusetts Centres for Outcomes Research (COR)

OBSERVATION.basic_demographic.v1, OBSERVATION.blood_pressure.v2, OBSERVATION.grace_acs_risk.v1, OBSERVATION.pulse.v2, OBSERVATION.lab_test-urea_and_electrolytes.v1