Observational studyClinical cardiology2016
Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome.
Observational study in Clinical cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The predictive value of machine learning for mortality risk in patients with acute coronary syndromes: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Low serum calcium is associated with higher long-term mortality in myocardial infarction patients from a population-based registry.Scientific reports · 2021Trial
- Article
- Correlation between albumin-corrected calcium levels and prognosis in non-ST-elevation myocardial infarction patients: a retrospective cohort study using the MIMIC-IV database.Journal of thoracic disease · 2025Article
- Early Serum Calcium Assessment as a Cost-Effective Tool in Risk Stratification of Acute Pancreatitis.Cureus · 2025Article
- Association between serum calcium level and the risk of acute kidney injury in patients with acute myocardial infarction: evidences from the MIMIC-IV database.Renal failure · 2024Article
- Association between serum calcium and in-hospital mortality in critically ill atrial fibrillation patients from the MIMIC IV database.Scientific reports · 2024Article
- Association between serum calcium level and the risk of acute kidney injury in ICU patients with subarachnoid hemorrhage: a retrospective cohort study.Frontiers in neurology · 2024Article
- Use of machine learning models to predict in-hospital mortality in patients with acute coronary syndrome.Clinical cardiology · 2023Article
- Propensity score analysis of red cell distribution width to serum calcium ratio in acute myocardial infarction as a predictor of in-hospital mortality.Frontiers in cardiovascular medicine · 2023Article
- Association between serum calcium level and in-hospital mortality in patients with acute myocardial infarction: a retrospective cohort study.Scientific reports · 2022Article
- Development and Validation of a Personalized Model With Transfer Learning for Acute Kidney Injury Risk Estimation Using Electronic Health Records.JAMA network open · 2022Article
- Admission high-sensitivity C-reactive protein levels improve the Grace risk score prediction on in-hospital outcomes in acute myocardial infarction patients.Clinical cardiology · 2022Article
- Effect of Admission Serum Calcium Levels and Length of Stay in Patients with Acute Pancreatitis: Data from the MIMIC-III Database.Emergency medicine international · 2022Article
- Association of admission serum calcium level with left ventricular dysfunction in patients with acute coronary syndrome.Frontiers in cardiovascular medicine · 2022Article
- Observational
- Diagnosis and prediction of COVID-19 severity: can biochemical tests and machine learning be used as prognostic indicators?Computers in biology and medicine · 2021Article
- Admission Serum Ionized and Total Calcium as New Predictors of Mortality in Patients with Cardiogenic Shock.BioMed research international · 2021Article
- The Prognostic Value of Calcium in Post-Cardiovascular Surgery Patients in the Intensive Care Unit.Frontiers in cardiovascular medicine · 2021Article
- Association between Serum Calcium and First Incident Acute Myocardial Infarction: A Cross-Sectional Study.Iranian journal of public health · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Global Registry of Acute Coronary Events (GRACE) risk score has been extensively validated to predict risk during hospitalization in patients with acute coronary syndrome (ACS). Recently, serum calcium has been suggested as an independent predictor for in-hospital mortality in patients with ST-segment elevation myocardial infarction; however, the relationship between the 2 has not been evaluated. HYPOTHESIS: The combination of GRACE risk score and serum calcium could provide better performance in risk prediction.
methodsThe study enrolled 2229 consecutive patients with ACS. Independent predictors were identified by a multivariate logistic regression model. The incremental prognostic value added by serum calcium to the GRACE score was evaluated by receiver operating characteristic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
resultsPatients in the upper quartiles of serum calcium presented with lower in-hospital mortality (odds ratios for 3 upper quartiles vs lowest quartile, respectively: 0.443, 95% confidence interval [CI]: 0.206-0.953; 0.243, 95% CI: 0.090-0.654; and 0.210, 95% CI: 0.082-0.538). Area under the curve increased significantly after adding serum calcium to the GRACE score (0.685 vs 0.746; Z = 2.617, P = 0.009). Furthermore, inclusion of serum calcium in the GRACE score enhanced NRI (0.524; P = 0.009) and IDI (0.011; P = 0.003).
conclusionsLower serum calcium level on admission is a possible indicator of increased risk of in-hospital mortality in ACS patients. Inclusion of serum calcium in the GRACE score may lead to a more accurate prediction of this risk. Large prospective studies are needed to confirm this finding.
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