A universal definition to identify patients at higher risk of complications after
percutaneous coronary intervention (PCI) is lacking. We aimed to validate a recently
developed score to identify patients at increased risk of all-cause death after PCI.
All consecutive patients from a large PCI registry not presenting with ST-elevation
myocardial infarction or cardiogenic shock were included. Each patient was assigned
a score obtained by summing the points associated with the following variables: age
>80 years (3 points), dialysis (6 points), left ventricular ejection fraction <30%
(2 points), and multivessel PCI (2 points). Patients were stratified in 3 groups:
low risk (score 0), intermediate risk (score 2 to 3), or high risk (score ≥4). The
primary outcome was all-cause death, and the secondary outcomes were major adverse
cardiovascular events and major bleeding. Events were assessed at 1 year after PCI.
Between January 2014 and December 2019, 12,689 patients underwent PCI. Compared with
the 9,884 patients at low risk, those at intermediate and high risk had a fourfold
(hazard ratio 3.99, 95% confidence interval 2.95 to 5.38) and ninefold (hazard ratio
9.55, 95% confidence interval 6.89 to 13.2) higher hazard for all-cause death at 1 year,
respectively. The score had a good predictive value for all-cause death at 1 year
(area under the curve 0.70). The risk of major adverse cardiovascular events and major
bleeding increased consistently from the low- to the high-risk group. In conclusion,
in patients who underwent PCI for stable ischemic heart disease or non–ST-elevation
acute coronary syndrome, a score based on 4 variables well predicted the risk of all-cause
death at 1 year.
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Article info
Publication history
Published online: December 06, 2022
Received in revised form:
October 29,
2022
Received:
July 6,
2022
Footnotes
Funding: none.
This study was supported by the Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai New York, New York.
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