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Incorporation of estimated glomerular filtration rate into the GRACE score improves its prognostic performance for 10-year outcome prediction in non-ST segment elevation acute coronary syndrome treated with percutaneous coronary intervention

Published:October 18, 2022DOI:https://doi.org/10.1016/j.ejim.2022.09.025
      Current guidelines for the management of patients with non-ST elevation acute coronary syndrome (NSTE-ACS) recommend the Global Registry of Acute Coronary Events (GRACE) score for risk stratification.
      • Collet JP
      • Thiele H
      • Barbato E
      • Barthélémy O
      • Bauersachs J
      • Bhatt DL
      ESC Scientific Document Group
      2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.
      ,
      • Gulati M
      • Levy PD
      • Mukherjee D
      • Amsterdam E
      • Bhatt DL
      • Birtcher KK
      • et al.
      2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
      Among the variables used in the score, serum creatinine (sCr) accounts for the prognostic impact of chronic kidney disease (CKD) in this setting.
      • Anavekar NS
      • McMurray JJ
      • Velazquez EJ
      • Solomon SD
      • Kober L
      • Rouleau JL
      • et al.
      Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction.
      However, estimated glomerular filtration rate (eGFR) is known to be a better measure of renal function than sCr. We developed two modified GRACE scores incorporating eGFR, as derived by two clinically validated formulas, and compared their long-term prognostic performance to that of the standard GRACE in a population of patients with NSTE-ACS.
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      References

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