Performance of the GRACE risk score 2.0 for predicting mortality and Medication Use in Acute Coronary Syndrome patients in Ho Chi Minh city

The Global Registry of Acute Coronary Event (GRACE) risk score was recommended to predict mortality in patients with acute coronary syndrome (ACS). Sufficient use of guidelinerecommended medications decreases post-discharge mortality rate in ACS patients. Evidence on the relationship between risk stratification and medication use in Vietnamese patients with ACS is limited. The objective of this study was to determine the relationship between risk stratification and medication use at discharge in ACS patients. This was a retrospective crosssectional study. Data was collected from medical records of all patients with ACS discharged from The Heart Institute in Ho Chi Minh city, Viet Nam between April and October, 2015. Patients were included if having information of 6-month mortality after discharge. The GRACE risk score version 2.0 was used to stratify patients into three risk subgroups. Prescribing indicators were used to assess the use of medications at discharge. Logistic regression was used to determine the relationship between risk stratification and medication use at discharge. There were 217 patients included. Regarding mortality risk within 6 months after discharge, 94 (43.3%) patients were classified into lowrisk group, 75 (34.6%) patients into moderate-risk group, and 48 (22.1%) patients into high-risk group. At discharge, antiplatelets were used in almost ACS patients (98.8%). The use of β-blockers was suboptimal (64.8%). Only 61.0% of patients were prescribed all guideline-recommended medications. There was a reverse association between risk stratification and medication use at discharge. The low use of β-blockers in ACS patients needs to be investigated, especially in high-risk patients.