Novel Risk Score Predicts Long-Term Mortality After PCI

Study, involving nearly 7,000 patients, included post-procedural complications to create score
By Eric Metcalf
HealthDay Reporter

WEDNESDAY, Sept. 8 (HealthDay News) -- A risk scoring model that includes post-procedural complications predicts long-term mortality in patients undergoing percutaneous coronary intervention (PCI), according to research published in the Sept. 1 issue of the American Journal of Cardiology.

Gabriel Maluenda, M.D., of the Washington Hospital Center in the District of Columbia, and colleagues reviewed the records of 6,932 patients who underwent PCI; patients presenting with cardiogenic shock were not included. The authors used baseline, angiographic, and procedural factors and post-procedural complications to create the risk score for estimating risk of death at one year. They validated the score in another set of 973 patients.

The researchers found that older age, history of diabetes, chronic renal failure, heart failure, left main coronary artery disease, lower baseline hematocrit, larger hematocrit decrease after the PCI, and Thrombolysis In Myocardial Infarction grade <3 flow after PCI were significantly correlated with outcome. The average receiver operating characteristic curve area in the validation group was 0.836.

"We presented a simple integer risk scoring model that includes pre-procedural, procedural, and post-procedural variables, which closely predicts long-term mortality in unselected patients undergoing contemporary PCI. This model, which was validated internally, highlights the significant impact of complications occurring after PCI on long-term outcomes. To our knowledge, this is the first risk model for long-term mortality to include post-procedural complications," the authors write.

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