Although the GRACE risk score is the most used scoring system for risk stratification in NSTE-ACS, little is known whether these risk score still maintain their performance in the current era with invasive strategies.

We aimed to investigate this issue in a contemporary population with NSTE-ACS managed invasively.

NSTE-ACS patients presenting at our cardiology department were included between 01 November 2015 and 31 October 2016. The primary outcome was mortality within three-year. The GRACE were calculated based on prospectively collected data. Discrimination and calibration were evaluated with the C statistic, in the whole population. A ROC curve was developed to define the Grace score cutoff that best predicts three-year mortality.

A total of 296 patients were evaluated: mean age was 62±12 years and 58% were male. The three-year mortality was 12.2%. Grace score in these patients was significantly higher (156.9±26.8 vs. 123.9±31.8; P<10⁻³). Grace score>137 showed a sensitivity of 86.0%, specificity of 68.1%. The area under the ROC curve was 0.79 (95% confidence interval of 0.72-0.86) (Figure 1).

The GRACE score for predicting three-year mortality still maintain a good performance in a contemporary study of patients with NSTE-ACS managed invasively.