Cardiología
Global Registry of Acute Coronary Events Score
Riesgo de mortalidad hospitalaria y a 6 meses en el SCA.
Contenido en inglés
Calculadora Escala GRACE
Resultado
105puntos
Riesgo bajo — mortalidad a 6 meses < 3%
Cómo usarla
- 1
Registrar las constantes al ingreso. Primera FC y PAS a la llegada.
- 2
Obtener la analítica de ingreso. Creatinina; anotar si la troponina/CK-MB está elevada.
- 3
Valorar el ECG y la clase Killip. La desviación nueva del ST suma 28 puntos; Killip ≥II añade 20.
Cuándo usarla
Apply to all patients presenting with NSTE-ACS (NSTEMI or unstable angina) to guide timing of coronary angiography and determine in-hospital and post-discharge prognosis.
- Estratificación del riesgo en SCASEST/angina inestable
- Un GRACE alto (>140) se beneficia de una estrategia invasiva precoz en 24 horas.
- SCACEST tras ICP
- Predice la mortalidad a 6 meses; orienta la intensidad de la rehabilitación.
- No es una herramienta de triaje aislada
- Usar junto con la curva de troponina y el contexto clínico.
Sobre la escala
The GRACE (Global Registry of Acute Coronary Events) score is the recommended risk stratification tool for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), including NSTEMI and unstable angina. It was derived from a multinational registry of over 100,000 ACS patients and predicts both in-hospital and 6-month mortality using eight clinical variables. The score directly informs the timing of coronary angiography: very high-risk patients require immediate invasive strategy (<2 hours), while high-risk patients should undergo early invasive strategy within 24 hours. ESC 2023 ACS guidelines designate GRACE as the preferred quantitative risk tool for NSTE-ACS.
Preguntas frecuentes
What is a high GRACE score?
A GRACE score >140 indicates high in-hospital mortality risk (>3%) and requires an early invasive strategy within 24 hours per ESC 2023 guidelines. Scores >200 in the context of haemodynamic instability constitute a very-high-risk presentation.
What is the difference between GRACE and TIMI score in ACS?
The GRACE score is more accurate and guideline-preferred for NSTE-ACS because it was derived from a larger real-world registry and incorporates continuous variables (age, BP, HR, creatinine). The TIMI score is simpler to calculate at the bedside but has lower discriminatory accuracy. ESC 2023 recommends GRACE for routine clinical use.
