Am Heart J. 2001 Feb;141(2):190-9. doi: 10.1067/mhj.2001.112404.
Acute coronary syndromes (ACS), including the spectrum of conditions from unstable angina to ST segment elevation myocardial infarction, represent a major cause of morbidity and mortality throughout the world. GRACE (the Global Registry of Acute Coronary Events) is a large, prospective, multinational observational study of patients hospitalized with ACS. The aim of GRACE is to improve the quality of care for patients with ACS by describing differences in, and relationships between, patient characteristics, treatment practices, and in-hospital and postdischarge outcomes at hospitals around the world. A goal of this study is to study approximately 10,000 patients with ACS on an annual basis.
A total of 18 cluster sites in 14 countries in North America, South America, Europe, Australia, and New Zealand are currently collaborating in GRACE. Clusters were chosen on the basis of local demographic characteristics and hospital facilities to ensure a representative sample of patients with ACS from each country. Patients are identified by use of either active or passive surveillance approaches. A standardized core case report form is completed for all patients. Information on patient demographics, medical history, acute symptoms, clinical characteristics, electrocardiographic findings, treatment approaches, and in-hospital outcomes is collected. Patients are followed up at 6 months after hospital discharge to identify recurrent coronary events, use of various medications, and mortality.
The information collected from the GRACE project will provide important and extensive insights into patient demographic and clinical characteristics, current practice patterns, and outcomes for patients with ACS from a number of countries throughout the world. Given the pressures of practicing evidence-based medicine, the results of GRACE should provide a multinational perspective into these important outcomes and identify practice variations that will allow new opportunities to improve patient care.
急性冠状动脉综合征（ACS），包括从不稳定型心绞痛到ST段抬高型心肌梗死的一系列病症，是全球发病和死亡的主要原因。全球急性冠状动脉事件注册研究（GRACE）是一项针对因ACS住院患者的大型、前瞻性、多国观察性研究。GRACE的目的是通过描述世界各地医院患者特征、治疗方法以及住院和出院后结果的差异及相互关系，来提高ACS患者的护理质量。本研究的一个目标是每年研究约10000例ACS患者。
目前，北美、南美、欧洲、澳大利亚和新西兰14个国家的18个聚类点正在GRACE项目中开展合作。聚类点是根据当地人口统计学特征和医院设施选定的，以确保每个国家ACS患者的代表性样本。通过主动或被动监测方法识别患者。为所有患者填写标准化的核心病例报告表。收集患者人口统计学、病史、急性症状、临床特征、心电图检查结果、治疗方法和住院结果等信息。患者在出院后6个月接受随访，以确定复发性冠状动脉事件、各种药物的使用情况和死亡率。
从GRACE项目收集的信息将为全球多个国家ACS患者的人口统计学和临床特征、当前实践模式及结果提供重要而广泛的见解。鉴于实施循证医学的压力，GRACE的结果应能提供关于这些重要结果的多国视角，并识别出实践差异，从而为改善患者护理带来新机遇。
