GRACE ACS Risk Score — Free Online Calculator
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GRACE ACS Risk Score
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About This Calculator
The GRACE (Global Registry of Acute Coronary Events) ACS Risk Score estimates in-hospital and 6-month mortality in patients with acute coronary syndromes (STEMI, NSTEMI, and unstable angina). It is one of the most widely validated ACS risk scores and is recommended by ACC/AHA and ESC guidelines for risk stratification to guide treatment decisions including invasive vs. conservative strategies.
Formula
Interpretation
| GRACE Score | Risk Level | In-Hospital Mortality |
|---|---|---|
| ≤ 108 | Low | < 1% |
| 109 – 140 | Intermediate | 1–3% |
| > 140 | High | > 3% |
References
- Fox KA, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091.
- Granger CB, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163(19):2345-2353.
Frequently Asked Questions
When should the GRACE score be calculated?
The GRACE score should be calculated at the time of hospital presentation for any patient with suspected acute coronary syndrome (ACS). It can be used for both STEMI and NSTEMI/unstable angina to guide risk-stratified management decisions.
How does the GRACE score guide treatment decisions?
High-risk GRACE scores (>140) support early invasive strategy (cardiac catheterization within 24 hours). Intermediate-risk patients (109–140) may benefit from early invasive or ischemia-guided approach. Low-risk patients (≤108) can often be managed with a conservative strategy.
Is GRACE better than TIMI for ACS risk assessment?
Multiple studies show GRACE has better discriminative ability than the TIMI risk score for predicting mortality in ACS. GRACE is recommended by both ESC and ACC/AHA guidelines for risk stratification in NSTE-ACS. However, TIMI remains simpler to calculate at the bedside.
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⚠ Medical Disclaimer
This tool is for educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for clinical decisions.