{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:40Z","timestamp":1782992740115,"version":"3.54.5"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The GRACE (Global Registry of Acute Coronary Events) score is well validated for risk stratification in non\u2013ST\u2010segment\u2013elevation myocardial infarction, but less well established in ST\u2010segment\u2013elevation myocardial infarction (STEMI), particularly relative to coronary disease burden. We therefore assessed its prognostic performance in a STEMI cohort, accounting for baseline coronary disease extent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We studied 1099 patients with STEMI from the CardioLines Coronary Biobank (2015\u20132021) with evaluable GRACE score and follow\u2010up data. Patients were stratified by the number of coronary vessels with significant stenosis. The primary end point was all\u2010cause death at 1\u2009year; the secondary end point was a combined end point, including all\u2010cause death, recurrent acute coronary syndrome, stroke, and revascularization at 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Mean GRACE scores increased with the number of diseased vessels (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). In multivariable models, each 10\u2010point increase in GRACE score was associated with a 31% higher risk of all\u2010cause death and a 14% higher risk of the combined end point at 1\u2009year. In single\u2010vessel disease, discrimination for all\u2010cause death was excellent early (30\u2010day area under the curve, 0.874 [95% CI, 0.755\u20130.991]) and moderate at 1 year (area under the curve, 0.77 [95% CI, 0.613\u20130.927]), but consistently poor in 3\u2010vessel disease (area under the curve, 0.52\u20130.57). Discrimination was significantly higher in single\u2010 versus multivessel disease at earlier time points, with differences attenuated by 1\u2009year. Stratified regression analyses confirmed stronger associations in single\u2010vessel versus multivessel disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this contemporary STEMI cohort, the GRACE score effectively stratifies event risk in single\u2010vessel but performs poorly in multivessel disease. These findings suggest variable prognostic utility of the GRACE score across anatomic disease burden post\u2010STEMI and caution when applying it across STEMI subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047124","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:41:50Z","timestamp":1773139310000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Coronary Artery Disease Extent on GRACE Risk Score Prognostic Performance After ST\u2010Segment\u2013Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3366-0702","authenticated-orcid":false,"given":"Kayode O.","family":"Kuku","sequence":"first","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5164-0599","authenticated-orcid":false,"given":"Chris","family":"Lenselink","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6273-9287","authenticated-orcid":false,"given":"Constantijn S.","family":"Venema","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-0471","authenticated-orcid":false,"given":"Hector M.","family":"Garcia\u2010Garcia","sequence":"additional","affiliation":[{"name":"MedStar Washington Hospital Center","place":["Washington"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"van der Harst","sequence":"additional","affiliation":[{"name":"University of Utrecht, University Medical Center Utrecht","place":["Utrecht, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7407-3064","authenticated-orcid":false,"given":"Erik","family":"Lipsic","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-4415","authenticated-orcid":false,"given":"Adriaan A.","family":"Voors","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-4084","authenticated-orcid":false,"given":"Joanna J.","family":"Wykrzykowska","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen","place":["Groningen, the 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