Risk scores are simple prognostication scheme that categorize a patient’s risk of death and ischemic events.

Their use can help tailor our therapies to match the intensity of the patient’s NSTE ACS,(non ST elevation Acute coronary Syndrome).
Knowing how time plays an important role in the management of ACS patients, the faster we can identify the high-risk patients the more the benefit can be achieved by administering the optimal treatment early.

For instance, high-risk patients will benefit more from very early invasive strategy while low-risk patients can be spared potentially harmful treatment.

USA guidelines state that “estimation of the level of risk is a multivariable problem that cannot be accurately quantified with a simple table” and the use of a risk score could only benefit, especially in women.

The ideal score for risk stratification on admission for NSTE ACS patients should have a good balance between complexity and utility. When the scores include continuous variables such as age, heart rate and serum creatinine they are more powerful, but also more complex to calculate.

Using the GRACE risk score, one could calculate even more precisely the risk and the associated mortality rate compared with other risk scores. In regard to the above discussed aspects, the GRACE risk score is more advantageous and easier to use in comparison with other available risk scores.

Hence, using GRACE risk score in the daily risk assessment of ACS patients can only help us. However, it should be emphasized that risk scores are clinical tools that can supplement but not replace sound clinical judgment.

Grace Score table to follow.

G Mohan.