Risk stratification in acute coronary syndrome: Evaluation of the GRACE and CRUSADE scores in the setting of a tertiary care centre

Abstract

Objective Risk assessment plays a decisive role in the management of acute coronary syndrome (ACS). The GRACE and the CRUSADE scores are among the most frequently used risk assessment tools. We aimed to compare the performance of the GRACE and CRUSADE risk scores to predict in‐hospital mortality and major bleeding in a contemporary ACS population at a high‐volume academic hospital. Methods All patients treated for ACS from January 1, 2006 to December 31, 2015 at a tertiary care centre were prospectively enrolled. We calculated GRACE and CRUSADE risk scores. We compared the discrimination capacity of both scores for in‐hospital mortality and major bleeding. Results In total 4087 patients (1151 [28.2%] female; age 62 ± 14 years) were included. Among these 2218 (54.3%) were diagnosed with ST‐elevation myocardial infarction, 113 (2.8%) died in hospital and major bleeding occurred in 65 (1.6%). Discrimination capacity for in‐hospital mortality of the GRACE score was superior to the CRUSADE score (receiver operator characteristic area under the curve (AUC) 0.91 (95% CI 0.89‐0.93) vs 0.83 (95% CI 0.80‐0.86); P < .01). Performance for major bleeding differed but was poor for both scores (AUC 0.71 [0.65‐0.76] for GRACE vs 0.61 [0.55‐0.68] for CRUSADE; P < .01). Conclusion The GRACE score appears to be superior over CRUSADE to predict in‐hospital mortality. Major bleeding is rare in the era of primary PCI and performance of both scores for this outcome was poor.

The Association between hs-CRP Levels with GRACE Score in Acute Coronary Syndrome Patients in H. Adam Malik Medan Central General Hospital

“…Our result was similar to Tscherny et al (2019), which reported the median Troponin I value of 9 ng/mL and CKMB of 53 U/L. [12] The mean cholesterol level in the study was 172.65 mg/dl, LDL 125.02 mg/dl, HDL 33.29 mg/dl, and triglyceride 134.47 mg/dl. Other studies also reported lipid profile results in ACS patients, in which the mean total cholesterol was 4.96 mmol/L, LDL 3.18 mmol/L, triglyceride 1.3 mmol/L, and HDL 1.16 mmol/L.…”

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

“…According to the degree of luminal narrowing, severity scores reflecting angiographic stenosis of the coronary artery segment were 1, 2, 4, 8, 16, and 32 for 0–25%, 26–50%, 51–75%, 76–90%, 91–99%, and 100%, respectively [ 15 ]. The Global Registry of Acute Coronary Event (GRACE) was widely used to risk stratification for ACS in acute phase [ 16 ]. For each AMI patient, GRACE score was calculated using online calculator on admission or within 24 h of admission ( http://www.outcomes-umassmed.org/grace ) by following variables: age, systolic blood pressure, heart rate, creatinine value, Killip class, cardiac arrest at admission, ST-segment deviation in ECG, and abnormal cardiac markers.…”

Association between Cystatin C and Cardiac Function in Acute Myocardial Infarction Patients: A Real-World Analysis

“…As the most frequently used risk assessment tools, the ‘Global Registry of Acute Coronary Events' (GRACE) and the ‘Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the American College of Cardiology/American Heart Association guidelines' (CRUSADE) scores were recommended in describing the severity and mortality risk of AMI patients and management [ 19 ]. The average GRACE and CRUSADE scores were 124.5 and 21.74 in all AMI patients, respectively.…”