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GRACE Score Calculator

  • Age (years)
  • Heart Rate (bpm)
  • Systolic Blood Pressure (mmHg)
  • Serum Creatinine (mg/dL)
  • Killip Class
  • ST-segment Deviation
  • Cardiac Arrest on Admission
  • Elevated Cardiac Enzymes (Troponin/CK-MB)
  • GRACE Score: Comprehensive Explanation and Clinical Context
    The Global Registry of Acute Coronary Events (GRACE) Score is a validated risk assessment tool designed to predict mortality in patients with Acute Coronary Syndrome (ACS). It integrates eight clinical variables-age, heart rate, systolic blood pressure, serum creatinine, Killip class, ST-segment deviation, cardiac arrest on admission, and cardiac enzyme elevation-to generate an individualized estimate of in-hospital or 6-month mortality.

    Normal Value and Interpretation
    There is no "normal" GRACE Score; rather, it stratifies risk:
    - Low risk: <109 points → <1% mortality
    - Intermediate risk: 109–140 points → 1–3% mortality
    - High risk: >140 points → >3% mortality

    Clinical Significance
    GRACE Score is endorsed by both the European Society of Cardiology (ESC) and the American Heart Association (AHA) as the preferred model for risk stratification in ACS. It guides decisions on early invasive strategies, intensive monitoring, and long-term prognosis.

    Clinical Interpretation Summary
    - GRACE Score >140 → Early invasive approach recommended (<24h).
    - GRACE Score 109–140 → Consider selective invasive approach.
    - GRACE Score <109 → Conservative management appropriate for stable cases.

    References:
    - Granger CB et al. Circulation. 2003;108:458–464. - Eagle KA et al. BMJ. 2009;338:b60. - Collet JP et al. 2020 ESC Guidelines for the management of Acute Coronary Syndromes. Eur Heart J. 2021;42:1289–1367.