title: Validity of the updated GRACE risk predictor (version 2.0) in patients with non-ST-elevation acute coronary syndrome.
abstract: OBJECTIVE
  A new version of the Global Registry of Acute Coronary Events (GRACE) risk score (version 2.0) has been released recently. The purpose of the present study was to assess the validity of GRACE 2.0 for in-hospital and 1-year mortality in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients.
  
  
  METHODS
  The prospective cohort comprised 396 consecutive NSTE-ACS patients admitted to a tertiary hospital between May 2012 and January 2013. The main outcome measure was the discrimination and calibration performance of GRACE 2.0, which were evaluated with the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit test, respectively.
  
  
  RESULTS
  In-hospital and 1-year mortality were 2% (8/396) and 12.4% (48/388), respectively. The discrimination performance was inadequate (AUC=0.62) for predicting in-hospital mortality for the overall cohort. Also, the calibration performance for in-hospital mortality could not be evaluated due to the low number of patients who died. At one year, the Hosmer-Lemeshow p-values for all subgroups were >0.05, suggesting a good model fit, and the discrimination performance was good (AUC=0.77) for the overall cohort, driven mainly by better accuracy for low-risk patients.
  
  
  CONCLUSIONS
  In a contemporary cohort of NSTE-ACS patients, GRACE 2.0 was valid for 1-year mortality assessment. Its value for in-hospital mortality requires validation in a larger cohort.
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. Electronic address: sukruakyuz@hotmail.com.
authors.forename: Sukru
authors.initials: S
authors.lastname: Akyuz
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Yazici
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Bozbeyoglu
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yildirimturk
authors.affiliation: Department of Cardiology, Suruc State Hospital, Sanliurfa, Turkey.
authors.forename: Denizhan
authors.initials: D
authors.lastname: Karacimen
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mert Ilker
authors.initials: MI
authors.lastname: Hayiroglu
authors.affiliation: Department of Cardiology, Ordu State Hospital, Ordu, Turkey.
authors.forename: Guney
authors.initials: G
authors.lastname: Erdogan
authors.affiliation: Department of Cardiology, Beykoz State Hospital, Istanbul, Turkey.
authors.forename: Abdullah Orcun
authors.initials: AO
authors.lastname: Oner
authors.affiliation: Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey.
authors.forename: Ali Nazmi
authors.initials: AN
authors.lastname: Calik
authors.affiliation: Department of Cardiology, Beykoz State Hospital, Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Cagdas
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Cam
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality*; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment
keywords: Acute coronary syndrome; Avaliação do risco; GRACE risk score; Mortalidade; Mortality; Prognosis; Prognóstico; Risk assessment; Score de risco GRACE; Síndrome coronária aguda