Will treating heart attacks with GRACE improve prognosis?

Effectiveness of the GRACE risk score on the management and outcome of patients hospitalised with non-ST elevation acute coronary syndrome

Dr Chris Gale and colleagues at the University of Leeds are studying whether the systematic use of the GRACE scoring system could help doctors improve their treatment of people who have had a heart attack or unstable angina. People admitted to hospital with a type of heart attack called NSTEMI or with unstable angina (where angina chest pain is not controlled) are more likely to experience another heart event in the following year. The likelihood of a repeat event depends on the person’s individual risk and medical history. Appropriate treatments, such as opening up the blocked artery and taking anticlotting drugs, can help people avoid further heart events. However, currently patients with the highest risk of experiencing another heart event often don’t receive appropriate treatments during their hospital admission. This is probably because doctors don’t always assess a patient’s risk correctly or they may not be aware of the potential benefits of treating high risk patients more intensively. Changing this practice could significantly improve outcomes for these patients. BHF-funded research by Professor Keith Fox and colleagues has led to the development of a cardiovascular risk scoring system for people admitted to hospital with a heart attack or unstable angina. Entering patient characteristics into the risk calculator generates a score that helps doctors identify high risk patients who need more intensive treatment. In this project, Dr Gale will lead an international trial using data from patients from the UK, Australia and Canada to find out whether implementing the GRACE scoring system systematically in hospitals improves the prognosis for people with NSTEMI and unstable angina by ensuring they receive the best treatment and reducing subsequent events such as death, heart attack and heart failure. This trial will find out if this new scoring system has the potential to prevent many people dying prematurely from heart disease.