Although the GRACE risk score is the most used scoring system for risk stratification in NSTE-ACS, little is known about whether these risk score still maintains their performance at log-term in the current era with invasive strategies.

We aimed to investigate this issue in a contemporary population with NSTE-ACS managed invasively.

NSTE-ACS patients presenting at our cardiology department were included. The primary outcome was cardiovascular mortality within 5-year. The GRACE was calculated based on prospectively collected data. Discrimination and calibration were evaluated with the C statistic, in the whole population. A ROC curve was developed to define the GRACE score cutoff that best predicts 5-year mortality and evaluated in a logistic regression with the backward elimination method.

In total, 274 patients were evaluated, the mean age was 62±12years and 58.8% were male. The 5-year cardiovascular mortality was 15.7%. GRACE score in these patients was significantly higher (154.6±28 vs. 121.9±30; P=10⁻³). GRACE score≥138 showed a sensitivity of 86.0% and specificity of 71.9%. The area under the ROC curve was 0.80 (95% confidence interval of 0.73–0.87) (Fig. 1).

The GRACE score for predicting long-term mortality still maintains its excellent performance in a contemporary study of patients with NSTE-ACS managed invasively.