The Global Registry of Acute Coronary Events (GRACE) score was developed from a multinational registry of 11,389 patients hospitalised with ACS across 94 hospitals in 14 countries from 1999-2001. Unlike the TIMI score (which uses binary yes/no criteria), GRACE uses continuous variables and weighted regression coefficients to generate a more precise prognostic score. The GRACE score was designed to predict both in-hospital and 6-month post-discharge mortality and has become the preferred ACS risk score in the European Society of Cardiology guidelines. GRACE 2.0 (2014) extended prediction to 1-year and 3-year mortality and removed the creatinine clearance calculation requirement, making it more accessible.