![]() ![]() Univariate analysis of dichotomous variables was performed using the χ 2 or Fisher’s exact test. Continuous variables are reported as the mean ± SD. Data were entered into a Microsoft Excel database and analysed using SPSS version 22.0. The GRACE score was calculated for each patient by adding the points for each of the eight prognostic variables used to calculate the score, namely age, history of heart failure, history of acute MI, heart rate and SBP at admission, ST-segment depression, serum creatinine at admission and elevated myocardial necrosis markers or enzymes ( Supplementary Material Figure 1). Out-of-hospital data, including death or late complications, were obtained via reviewing patient outpatient clinic notes. Most of the information was obtained between January and April 2018 from an in-house database, which included 10 patient-related factors, five cardiac-related factors and three operation-related factors. 5,6 The eight variables that constitute the GRACE score are age, history of heart failure, history of acute MI, heart rate and systolic blood pressure (SBP) at admission, ST-segment depression, serum creatinine at admission and elevated myocardial necrosis markers or enzymes.įor this retrospective study, a database was created to collect relevant data, which were then stored in spreadsheets, and in accordance with the GRACE score variables. The GRACE score was calculated using the online calculator (Version 2.0 ), as described previously. A diagnosis of ACS was made based on presenting symptoms, ECG and cardiac biomarkers.All patients were treated with dual anti-platelet therapy, anticoagulants, statins, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers and β-blockers where possible. The study included all patients presenting with chest pain suggestive of ACS and admitted for further treatment. The initial cohort contained 440 patients, but 12 (2.7%) patients were excluded because they did not have valid data for calculating the GRACE score or vital status 6 months after discharge. This study included 428 patients aged ≥18 years who were admitted to Hospital Sultanah Aminah, Johor Bahru, Malaysia, between January and April 2018 for acute coronary syndrome (ACS). 4 Thus, the aim of this study was to validate the GRACE risk score in an Asian medical centre to determine whether the probabilistic model can be used outside of the geographical and patient environment in which it was created. We must be mindful of the geographical differences and patient characteristics in the original GRACE study when applying this risk score to other populations, with validation required to avoid erroneous results in risk calculations. It uses a predictive logistic model with eight prognostic variables ( Supplementary Material Figure 1) to determine a patient’s probability of death due to any cause during the first 6 months after discharge. The GRACE risk score predicts 6-month mortality after a patient has been discharged following hospital admission for ACS. The GRACE registry, a global registry of ACS patients from 94 hospitals in 14 countries, developed two models to estimate the risk of in-hospital and 6-month mortality among all patients with ACS. There are various risk scores to predict mortality risk among patients admitted for acute coronary syndrome (ACS), such as the Thrombolysis in MI (TIMI) score, Global Registry of Acute Coronary Events (GRACE) risk score and the Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin (eptifibatide) Therapy (PURSUIT) score. Conclusion: This study validated the GRACE score for predicting 6-month mortality among patients admitted to an Asian medical centre for ACS and recommended that it is used routinely ![]() The GRACE risk score was calibrated and validated, showing an adequate capacity for discrimination with a receiver operating characteristic area under the curve of 0.831 (95% CI p<0.001). By 6 months after discharge, 66 (15%) patients had died. Results: Of the 428 patients in this study, 92 (21.5%) were admitted for STelevation MI (STEMI), 128 (29.9%) were admitted for non-STEMI and 208 (48.6) were admitted for unstable angina. The survival status of patients 6 months after hospital discharge was calculated using the GRACE risk score, and the validity of the GRACE risk score was evaluated by assessing its calibration (Hosmer–Lemeshow test) and discriminatory capacity. Methods: This study validated the GRACE score in a contemporary cohort of 428 patients aged ≥18 years admitted to Hospital Sultanah Aminah Johor Bahru between January and April 2018 for ACS. Background: The Global Registry of Acute Coronary Syndrome (GRACE) risk score is used to provide an estimate of 6-month mortality among patients admitted for acute coronary syndrome (ACS). ![]()
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