Table 1.
Risk Score | GRACE ( 37 ) | GRACE 2.0 (38) | TIMI ( 37 ) | TARRACO ( 37, 40) |
---|---|---|---|---|
Variables |
Age Heart rate Systolic blood pressure CHF Killip class Creatinine ST-segment deviation Elevated troponin Cardiac arrest at admission |
Age Heart rate Systolic blood pressure CHF Killip class Creatinine ST-segment deviation Elevated troponin Cardiac arrest at admission Diuretic use* Renal failure* |
Age >=65 >=3 CAD risk factors Known CAD (stenosis >=50%) Aspirin use in past 7 days Severe angina (>=2 episodes in 24 hours) ECG ST changes >=0.5 mm Positive cardiac marker |
Age Arterial hypertension. Absence of chest pain. Dyspnea. Anemia. Troponin >5 URL. |
Original endpoint |
At admission: in-hospital/to 6 months At discharge (to 6 months) |
Death: in-hospital, to 6 months, 1 year, and 3 years. Death/MI: 1 year. |
All-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization through 14 days | Post-discharge major adverse cardiac events at 180-days including all-cause death and readmission for congestive heart failure or acute MI |
T2MI performance (AUC) |
All-cause mortality: In-hospital: 0.66 30-day: 0.69 90-day: 0.70 CV death In-hospital: 0.69 30-day: 0.72 90-day: 0.74 CV death, stroke, recurrent T1MI or T2MI In-hospital: 0.52 30-day: 0.58 90-day: 0.57 |
All-cause mortality * In-hospital: Scottish: 0.67 Swedish: 0.82 * 1 ear: Scottish: 0.73 Swedish: 0.73 Death or MI * 1 ear: Scottish: 0.70 Swedish: 0.72 |
All-cause mortality: In-hospital: 0.55 30-day: 0.43 90-day: 0.54 CV death In-hospital: 0.75 30-day: 0.67 90-day: 0.68 CV death, stroke, recurrent T1MI or T2MI In-hospital: 0.61 30-day: 0.61 90-day: 0.58 |
180-day all-cause death and readmission for CHF or acute MI Cediel et al. Derivation: 0.75 Validation: 0.74 All-cause mortality: In-hospital: 0.51 30-day: 0.51 90-day: 0.52 CV death In-hospital: 0.49 30-day: 0.46 90-day: 0.47 CV death, stroke, recurrent T1MI or T2MI In-hospital: 0.46 30-day: 0.49 90-day: 0.47 |
GRACE 2.0 recalibrated the original score using nonlinear associations for continuous variables to improve discrimination and calibration and provides an individual percentage risk. The algorithm was simplified by incorporating diuretic use and renal failure as categorical surrogates where creatinine or Killip class was not recorded. Abbreviations: CHF: congestive heart failure; AUC: Area Under the Curve; CAD: coronary artery disease; ECG: electrocardiogram; URL: upper reference limit; MI: myocardial infarction; CV: cardiovascular.