GRACE Score and Invasive Timing — EECC MCQ
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Correct answer: C — Within 24 hours of admission
The 2023 ESC ACS Guidelines use risk stratification to determine the timing of invasive coronary angiography in NSTE-ACS. Immediate (<2 hours): very high risk — ongoing chest pain, haemodynamic instability, life-threatening arrhythmias, acute HF, recurrent dynamic ST changes. Early (<24 hours): high risk — GRACE score >140, troponin rise/fall, dynamic ST/T-wave changes. Selective invasive (<72 hours): intermediate risk — diabetes, eGFR <60, LVEF <40%, early post-infarction angina, prior PCI/CABG. A GRACE score of 155 places this patient in the high-risk category requiring early invasive strategy within 24 hours.
Reference: ESC (2023): Guidelines for the Management of Acute Coronary Syndromes