Validation of the GRACE score for prognosis in Indian patients with acute coronary syndromes.
OBJECTIVE
To validate the global registry of acute coronary events (GRACE) score in acute coronary syndromes (ACS) patients and study its angiographic correlation.


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.


CONCLUSIONS
Higher GRACE score predicts in-hospital events and more severe angiographic coronary artery disease (CAD).
Department of Cardiology, St. John's Medical College and Hospital, Bengaluru - 34, Karnataka, India. amar_goa@rediffmail.com
Amar R
AR
Prabhudesai
M A
MA
Srilakshmi
M J
MJ
Santosh
Gurappa G
GG
Shetty
Kiron
K
Varghese
Chandrakant B
CB
Patil
Shamanna S
SS
Iyengar
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D000368:Aged; D017023:Coronary Angiography; D005260:Female; D006305:Health Status Indicators; D006760:Hospitalization; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment