Prognostic value of GRACE and EDACS scores in non-STEMI patients presenting to the emergency department.

Objectives: This study primarily aimed to evaluate the association of EDACS and GRACE scores with angiographically significant coronary lesions in patients presenting with NSTEMI. The secondary objective was to assess their relationship with 30-day mortality. Methods: This retrospective single-center study included adults diagnosed with NSTEMI between January 2022 and December 2024. Demographic and clinical characteristics, GRACE and EDACS scores, angiographic findings, and 30-day mortality were obtained from electronic hospital records. Significant coronary lesions were defined as ≥70 % stenosis or the need for stent placement. Statistical analyses included Mann-Whitney U, Chi-square, logistic regression, and ROC analyses. Results: Among 332 patients, both GRACE and EDACS scores were significantly higher in non-survivors. GRACE high-risk classification was strongly associated with mortality, whilst EDACS (≥16) showed a non-significant trend. EDACS demonstrated superior discriminatory ability for significant coronary lesions, whereas GRACE was more closely associated with mortality risk. An EDACS cut-off >12.5 yielded 87.7 % sensitivity and 40.0 % specificity. Logistic regression identified male sex, hypercholesterolaemia, EDACS ≥16, and systolic blood pressure as independent predictors of significant lesions. Conclusions: GRACE predicted mortality, whereas EDACS better identified significant coronary lesions; combined use showed marginal improvement in model fit but did not significantly enhance discriminatory performance.