We assessed the interest of systematically using the GRACE scoring system (in addition to clinical assessment) for in- hospital outcomes and bleeding complications in the management of NSTEMI compared with clinical assessments alone. Multicentre, randomized study that included 572 consecutive NSTEMI patients, randomized 1:1, into group A: clinical stratification alone and group B: clinical+ GRACE score stratification.

Main outcome measures: in-hospital outcomes and bleeding complications. There was no significant difference between the two groups for baseline data or for in-hospital MACE. In multivariate analysis, only a GRACE 140 (OR: 3.5, 95 % CI: 1.8-6.6, p 140, and these patients were significantly older, and were more likely to have a history of diabetes, stroke and renal failure, together with symptoms of heart failure. After multivariate analysis, the independent predictors of a lack of compliance with guideline delays were a GRACE score 140 (OR: 9.2; CI: 4.2-20.3, p

GRACE Score Myocardial infarction NSTEMI Risk stratification