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GRACE risk score has been shown to provide clinically relevant stratification of follow-up HF admission risk at the time of hospital discharge in patients with ACS.

The six-month GRACE risk score is a useful tool to predict 30-day post-discharge death and early cardiovascular readmission. Clinicians may find it simple to use with the online and mobile app score calculator and applicable to clinical daily practice.

Objectives: Given the increasing focus on early mortality and readmission rates among patients with acute coronary syndrome (ACS), this study was designed to evaluate the accuracy of the GRACE risk score for identifying patients at high risk of 30-day post-discharge mortality and cardiovascular readmission. Methods: This was a retrospective study carried out in a single center with 4229 ACS patients discharged between 2004 and 2010. The study endpoint was the combination of 30-day postdischarge mortality and readmission due to reinfarction, heart failure or stroke. Results: One hundred and fourteen patients had 30-day events: 0.7% mortality, 1% reinfarction, 1.3% heart failure, and 0.2% stroke. After multivariate analysis, the six-month GRACE risk score was associated with an increased risk of 30-day events (HR 1.03, 95% CI 1.02---1.04; p<0.001), demonstrating good discrimination (C-statistic: 0.79±0.02) and optimal fit (Hosmer---Lemeshow p=0.83). The sensitivity and specificity were adequate (78.1% and 63.3%, respectively), and negative predictive value was excellent (99.1%). In separate analyses for each event of interest (all-cause mortality, reinfarction, heart failure and stroke), assessment of the six-month GRACE risk score also demonstrated good discrimination and fit, as well as adequate predictive values.S. Raposeiras-Roubín et al. Conclusions:The six-month GRACE risk score is a useful tool to predict 30-day post-discharge death and early cardiovascular readmission. Clinicians may find it simple to use with the online and mobile app score calculator and applicable to clinical daily practice. Score de risco GRACE; Eventos aos 30 dias; Mortalidade; Reenfarte; Insuficiência cardíaca; Acidente vascular cerebral Mortalidade e morbilidade cardiovascular nos primeiros 30 dias após uma síndrome coronária aguda num coorte contemporâneo europeu de doentes: como podemos melhorar a predição precoce de risco? O score de risco GRACE aos seis meses ResumoObjetivos: Tendo em conta a importância crescente das taxas de mortalidade e readmissão precoce nos doentes com síndrome coronária aguda (SCA), realizámos este estudo que pretende avaliar a precisão do score de risco GRACE na identificação dos doentes com risco elevado de readmissão e mortalidade cardiovascular no primeiro mês após a alta. Método: Estudo retrospetivo efetuado num único centro com 4229 doentes com SCA com alta entre 2004-2010. Objetivo primário foi a combinação de mortalidade e readmissão por reenfarte, insuficiência cardíaca ou acidente vascular cerebral aos 30 dias após a alta. Resultados: Cento e catorze doentes tiveram eventos aos 30 dias: mortalidade 2,7%; reenfarte 1%; insuficiência cardíaca 1,3%; e acidente vascular cerebral 0,2%. Após uma análise multivariada, o score de risco GRACE aos seis meses esteve associado com um maior risco de eventos aos 30 dias (HR 1,03, IC 95% 1,02-1,04, p<0,001), demonstrando uma boa discriminação (C-statistics: 0,79±0,02) com uma calibração ótima (HL p: 0,83). A sensibilidade e especificidade foram adequadas (78,1-...

Systemic sclerosis (SS) is a chronic disease in which there may be multisystem involvement. It is rare (estimated prevalence: 0.5-2/10000) with high morbidity and mortality, and there is as yet no curative treatment. We report the case of a young woman newly diagnosed with SS, in whom decompensated heart failure was the main manifestation.

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