Korean J Crit Care Med.  2006 Dec;21(2):101-108.

Clinical Value of GRACE Score in the Prediction of Mortality in Patients with Acute Coronary Syndrome

Affiliations
  • 1The Heart Center and Coronary Care Unit of Chonnam National University Hospital, Korea. myungho@chollian.net
  • 2Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.

Abstract

BACKGROUND
This study was aimed to evaluate the validity of the Global Registry of Acute Coronary Event (GRACE) in patients with acute coronary syndrome (ACS).
METHODS
One thousand thirty hundred seventy eight patients (63.6+/-12.0 years, 921 male), who were admitted at coronary care unit (CCU) of Chonnam National University Hospital between January 2004 and December 2005, were analyzed. The patients were divided into two groups: the survived group (n=1,298, 871 male, 63.1+/-9.7 years) and the moribund group (n=80, 50 male, 67.4+/-8.5 years). Clinical characteristics, risk factors for atherosclerosis, echocardiographic findings, GRACE score and NT-proBNP were compared between groups.
RESULTS
The overall mortality was 5.8 %, 80 out of 1,378 patients. Mortality was higher in patients with Killip IV (46.7%, 50 out of 107 patients) than Killip II or III and elderly patients more than 80 years (42.7%, 38 out of 89 patients). High Killip class and old age were associated with high mortality (p<0.0001 respectively). Total score of GRACE was elevated in the moribund group (142+/-40.3 vs. 240+/-40.0) and high GRACE score was significant predictor of mortality (p<0.0001, r=0.827). Predictive factors for mortality by multiple logistic regression analysis were GRACE score (OR 1.15, 1.11~1.20 95%CI, p<0.0001) and old age (OR 0.88, 1.14~1.33 95%CI, p<0.001).
CONCLUSIONS
GRACE score is useful predictor for the mortality of ACS at CCU.

Keyword

Acute coronary syndrome; GRACE score; Prognosis

MeSH Terms

Acute Coronary Syndrome*
Aged
Atherosclerosis
Coronary Care Units
Echocardiography
Humans
Jeollanam-do
Logistic Models
Male
Mortality*
Prognosis
Risk Factors
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