The study was conducted after the approval of ethical review committee of the institution. Patients with prior history of cardiac-related surgery or intervention and ST elevation myocardial infarction and patients who refuse to give consent were excluded from the study. Patients with NSTE-ACS of age more than 30 years of either gender were included in the study. Sample size for the study was 294 ≈ 300 patients. Sample size was estimated by using OpenEpi online sample size calculator using 95% confidence level, 5.6% margin of error, and statistics for GRACE score ≥ 217 for predicting in-hospital mortality as 39.7%. It was an observational study conducted at the department of a tertiary care cardiac center of Karachi, Pakistan, from August 2019 to August 2020. The goal of the current research is therefore to evaluate the predictive importance of the GRACE score for predicting in-hospital and 6-month non-ST acute coronary syndrome (NSTE-ACS) mortality. In Pakistan, coronary diseases have been the leading causes of morbidity and mortality. The parameters of the GRACE score (range 2 to 372) are heart rate, age, systolic blood pressure, cardiac arrest, Killip class, ST segment deviation, serum creatinine, and cardiac biomarker status. The GRACE score was validated in various databases and c-statistics of the GRACE score was estimated to be 0.83 in the original database. It has been observed that the odds of in-hospital mortality have increased significantly with increase in GRACE score. GRACE score is one of the score that was developed to identify patients in the coronary care unit or emergency department at the greatest risk of adverse events after ACS. There are many risk scores for ACS risk stratification. Currently, there is actually no evidence based risk stratification and guidelines for these patients. A huge number of patients with chest pain due to factors other than ACS were not assessed in these studies. But none of the scoring systems were used to identify the ACS in the emergency room. The risk scores such as the thrombolysis in myocardial infarction (TIMI), platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using integrilin (PURSUIT), fast revascularization in instability in coronary disease (FRISC), and Global Registry of Acute Coronary Events (GRACE) are well validated in this regard. For patients with confirmed ACS diagnosis, various scoring systems may be used in order to differentiate patients in the coronary care unit that benefit more from the treatments. Īccurate stratification of risk factors and diagnostic evaluation are of the highest significance not just for primary prevention but even for the prevention of repeated coronary ischemia or infarction attacks. Life-saving therapies for ACS patients are strongly dependent on early and prompt identification of signs and symptoms, whereas atypical appearance of ACS symptoms may lead to delayed diagnosis, delayed care, less evidence-based approaches, and increased morbidity and mortality. The clinical characteristics of ACS, including ST segment elevation of myocardial infarction (STEMI), non-STEMI, and unstable angina, is known to be widespread causes for disability and mortality. Acute coronary syndrome (ACS) is a syndrome caused by decreased blood flow in the coronary arteries.
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