GRACE ACS Risk and Mortality Calculator
Estimates admission to 6 month mortality for patients with acute coronary syndrome.
The GRACE Score (2.0) can be used in patients with acute coronary syndrome using commonly obtained clinical variables. It can support risk stratification for an early invasive strategy.
For patients with STEMI, it can provide prognostic information but should not delay reperfusion. Always interpret this score with troponin values, ECG, and clinical judgement.
Advice
- The GRACE Score is a prognostic tool to support decision-making; use it alongside clinical judgment, ECG, troponin, and patient stability.
- Discuss results with patients and families to guide expectations and shared decisions.
Management
- The ESC 2023 and ACC/AHA 2025 acute coronary syndrome guidelines support the use of the GRACE score to identify high-risk patients with acute coronary syndrome for risk stratification to early invasive strategy (score >140).
- In patients with STEMI, results should not delay an invasive strategy but can be used to provide prognostic information.
Critical Actions
- Mortality estimate increases as the GRACE score increases.
- Results can be used as one factor in determining a course of care and may assist in communication with the patient about their risk; it should not be used in isolation when determining a treatment plan.
- Ensure high-risk patients have guideline-directed care during their hospitalization, as well as appropriate specialist and primary care follow-up upon discharge.