• Public health

To the Editor: The recent editorial in Heart by Fox and Mclean concludes ‘The NICE guidance on chest pain provides a series of important advances over the current status of investigation and triage of chest pain and should be welcomed by the profession’.1 One of the key recommendations of the recently published National Institute for Health and Clinical excellence (NICE) guidelines for the early management of unstable angina and non-ST segment elevation myocardial infarction is the formal assessment of individual risk of future adverse cardiovascular events using the Global Registry of Acute Coronary Events (GRACE) risk stratification score.2 GRACE is a simple risk model that is able to predict the level of risk for individual patients for inhospital and 6-month risks of mortality and mortality or myocardial infarction (MI), based on outcome data derived from a large, multinational, prospective observational study of patients with an acute …