{"id":"5028ff9bf6c2","type":"article","url":"https://hartvaat.nl/2021/07/08/grace-2-0-score-bij-type-1-en-type-2-mi/","title":"GRACE 2.0-score bij type 1 en type 2 MI","title_en":"Performance of the GRACE 2.0 score in patients with type 1 and type 2 myocardial infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaa375","source_url":"https://doi.org/10.1093/eurheartj/ehaa375","authors":["John Hung","Andreas Roos","Erik Kadesjö","David A McAllister","Dorien M Kimenai","Anoop S V Shah","Atul Anand","Fiona E Strachan","Keith A A Fox","Nicholas L Mills","Andrew R Chapman","Martin J Holzmann"],"significance":5,"published":"2021-07-08","source_date":"2021-07-08","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This analysis showed that the GRACE 2.0 risk score performs well for type 1 MI but has limited accuracy for type 2 MI, suggesting the need for separate risk models for demand-type myocardial infarction.","created":"2026-07-03T10:29:16Z","updated":"2026-07-03T13:28:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van de prestatie van de GRACE 2.0-risicoscore bij patiënten met type 1 versus type 2 myocardinfarct.","abstract_original":"AIMS: The Global Registry of Acute Coronary Events (GRACE) score was developed to evaluate risk in patients with myocardial infarction. However, its performance in type 2 myocardial infarction is uncertain. METHODS AND RESULTS: In two cohorts of consecutive patients with suspected acute coronary syndrome from 10 hospitals in Scotland (n = 48 282) and a tertiary care hospital in Sweden (n = 22 589), we calculated the GRACE 2.0 score to estimate death at 1 year. Discrimination was evaluated by the area under the receiver operating curve (AUC), and compared for those with an adjudicated diagnosis of type 1 and type 2 myocardial infarction using DeLong's test. Type 1 myocardial infarction was diagnosed in 4981 (10%) and 1080 (5%) patients in Scotland and Sweden, respectively. At 1 year, 720 (15%) and 112 (10%) patients died with an AUC for the GRACE 2.0 score of 0.83 [95% confidence interval (CI) 0.82-0.85] and 0.85 (95% CI 0.81-0.89). Type 2 myocardial infarction occurred in 1121 (2%) and 247 (1%) patients in Scotland and Sweden, respectively, with 258 (23%) and 57 (23%) deaths at 1 year. The AUC was 0.73 (95% CI 0.70-0.77) and 0.73 (95% CI 0.66-0.81) in type 2 myocardial infarction, which was lower than for type 1 myocardial infarction in both cohorts (P < 0.001 and P = 0.008, respectively). CONCLUSION: The GRACE 2.0 score provided good discrimination for all-cause death at 1 year in patients with type 1 myocardial infarction, and moderate discrimination for those with type 2 myocardial infarction. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT01852123."}