Question: Does the modified GRACE score incorporating continuous troponin improve ACS risk prediction?
Methods: Retrospective longitudinal cohort study examining 3 independent cohorts (2 derivation and 1 validation).
Findings: The modified GRACE score incorporating continuous troponin (rather than binary) showed improved performance compared with the original GRACE score and other well-established prognostic markers.
Limitations: The recruitment periods of both the derivation and validation cohorts have significant overlap, thus predisposing the data to bias.
Interpretation: Modified GRACE score improved prediction of short-term and long-term mortality across the spectrum of ACS. Prior to widespread adoption, prospective cohort studies should be performed.
By: Dr. Kevin Durr
JC Supervisor: Dr. Jeff Perry