Accuracy of the Global Registry of Acute Coronary Events (GRACE) Risk Score in Contemporary Treatment of Patients With Acute Coronary Syndrome - The 66th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery

GIL BEERI ¹ Mony Shuvy ² Eyal Klein ² Tal Cohen ^3,4 Nir Shlomo ^3,4 Saar Minha ^4,5 David Pereg ^1,4

¹Cardiology Department, Meir Medical Center
²Heart Institute, Hadassah-Hebrew University Medical Center
³Department of Cardiology, Sheba Medical Center
⁴Sackler Faculty of Medicine, Tel-Aviv University
⁵Cardiology Department, Assaf-Harofeh Medical Center

Background: Global Registry of Acute Coronary Events (GRACE) score has been routinely used for risk stratification in acute coronary syndromes. We aimed to investigate whether the GRACE score has remained relevant with contemporary treatment of patients with ACS.

Methods: Included were patients with ACS in the Acute Coronary Syndrome Israeli Survey. Patients were divided into high (> 140) and low intermediate (_ 140) GRACE score. Outcomes were compared for each GRACE score group among patients enrolled in early (2000 to 2006), mid (2008 to 2010) and late (2013 to 2016) surveys.

Results: Included were 4931 patients. For patients with GRACE scores > 140, temporal improvements in therapy were associated with reduced 7-day all-cause mortality (5.7%, 4.1%, and 2.0% for patients in early, mid-, and late surveys, respectively, P ¼ 0.01) and 1-year mortality rates (27.8%, 25.3%, and 21.8% for patients in early, mid-, and late surveys, respectively, P ¼ 0.07). Among patients with GRACE scores _ 140, all-cause mortality rates at 1 year were lower among participants enrolled in recent surveys (5.3%, 3.5%, and 3.1% for patients in early, mid-, and late surveys, respectively, P ¼ 0.01).

No significant differences in the accuracy of the GRACE score in predicting