GRACE ACS Risk Score
Global Registry of Acute Coronary Events (GRACE) score. Predicts in-hospital and 6-month mortality in patients with ACS (STEMI, NSTEMI, UA). The recommended risk stratification tool in ESC NSTEMI guidelines.
Score interpretation
→ GRACE Low Risk (<109): In-hospital mortality <1%. Conservative or early invasive strategy based on clinical assessment. Angiography within 72 hours for NSTEMI per ESC guidelines.
→ GRACE Intermediate Risk (109–140): In-hospital mortality 1–3%. Early invasive strategy within 24 hours; dual antiplatelet therapy; anticoagulation; cardiology review.
→ GRACE High Risk (>140): In-hospital mortality >3% (up to >9% if >170). Urgent invasive strategy within 2 hours if ongoing ischaemia/haemodynamic instability; otherwise within 24 hours. ICU monitoring; consider GPIIb/IIIa if PCI.
Interpretation bands for the GRACE Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine (IV — Anaesthesia/ICU) · Local Anaesthetic / Antiarrhythmic (Class Ib)
- Amiodarone (IV — ICU/Peri-Arrest) · Antiarrhythmic (Class III)
- Lidocaine hydrochloride · Amide local anaesthetic / Class IB antiarrhythmic
- Flecainide · Class IC Antiarrhythmic
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.