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🫀 ACS GRACE Risk (framework)

UseUse for NSTE-ACS risk stratification: invasive-strategy timing [pending update], interpreted alongside guidel…

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StrataIn-hospital risk bands [pending update]. [Pending update] Some thresholds, grades and management recommendati…

LimitsNonlinear nomogram — do not approximate with a linear sum on this pag… · Cardiac arrest and Killip class dominate risk; verify vitals and crea… · Use with troponin trajectory and bleeding risk when choosing anticoag…

SourceGranger CB, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events…

Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders

This-shift next steps

After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.

Who it is for
Adults with emergency chest pain when deciding observation, rule-out, or ACS.
Who it is not for
Chest pain already clearly non-cardiac. No new ECG score.
Formula and variables
HEART is history, ECG, age, risk factors, and troponin. GRACE is age, heart rate, systolic pressure, creatinine, Killip, arrest, ST shift, and marker; the variant stays as on this page. TIMI and TIMI STEMI both exist; this page does not pick a new variant. Killip is pump class. No new chest-pain score.
Result → next step
Low risk stays with this page’s rule-out or observation. Once ACS is established, the next page is reperfusion and antithrombotic care. Bleeding uses CRUSADE. Stent duration uses the DAPT page. No loading dose is written.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.ACS reperfusion / antithrombotic →
Guideline
2023 ESC ACS
Scene next step
📋ED chest pain / ACSOpen scene pack →
Related scores
Matching pathway
🧭nste_acsOpen pathway →
Score + version; reference only — not a substitute for care · no HIS write

Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.

Methodology · worked example, guidelines & full notes
Clinical takeaway

The numerous band cut-points make the score unsuitable for on-platform reproduction; this page provides the inputs and risk bands and defers the exact score to the official calculator. (original synthesis · not guideline verbatim)

When to use

Use for NSTE-ACS risk stratification: invasive-strategy timing [pending update], interpreted alongside guidelines and the clinical picture.

How it works

Eight variables — age, heart rate, systolic BP, serum creatinine, Killip class, cardiac arrest at admission, ECG ST-segment deviation, elevated cardiac markers — mapped through a nomogram. In-hospital bands: low ≤108, intermediate 109–140, high [pending update].

Key points

  • The numerous band cut-points make the score unsuitable for on-platform reproduction; this page provides the inputs and risk bands and defers the exact score to the official calculator. (original synthesis · not guideline verbatim)
  • In-hospital mortality bands: ≤108 (<1%), 109–140 (1–3%), [pending update](>3%); 6-month: ≤88, 89–118, >118.
  • GRACE is a guideline-endorsed tool for timing the invasive strategy in NSTE-ACS.

References

Worked calculation

The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.

Show required inputs, risk bands and official linkShow

→GRACEReference framework (use official calculator)

  • Nature：The GRACE score converts 8 variables into a mortality probability via a banded look-up / nonlinear regression (nomogram) with numerous band cut-points. To avoid fabricating the look-up, this tool lists the required 8 items and risk bands and provides the official calculator; it does not output fabricated scores/probabilities
  • 8 inputs：Age, heart rate, systolic BP, serum creatinine, Killip class, cardiac arrest at admission, ECG ST-segment deviation, elevated cardiac necrosis markers
  • In-hospital mortality bands：Low ≤ 108 (< 1%), intermediate 109–140 (1–3%), high [pending update](> 3%)
Verification & sources · governance
FAQ

Frequently asked questions

Does ACS GRACE Risk (framework) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is ACS GRACE Risk (framework) calculated in practice? Can you show a worked example?
Inputs: Show required inputs, risk bands and official link Show → Result: GRACE Reference framework (use official calculator)（Nature: The GRACE score converts 8 variables into a mortality probability via a banded look-up / nonlinear regression (nomogram) with numerous band cut-points. To avoid fabricating the look-up, this tool lists the required 8 items and risk bands and provides the official calculator; it does not output fabricated scores/probabilities, 8 inputs: Age, heart rate, systolic BP, serum creatinine, Killip class, cardiac arrest at admission, ECG ST-segment deviation, elevated cardiac necrosis markers, In-hospital mortality bands: Low ≤ 108 (< 1%), intermediate 109–140 (1–3%), high [pending update](> 3%)）
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