Kimmel et al described a simple predictive index for identifying patients at risk for complications following percutaneous transluminal coronary angioplasty. This can help identify patients who may require closer monitoring or more aggressive care. The authors are from University of Pennsylvania in Philadelphia.
Complications:
(1) myocardial infarction
(2) emergency coronary artery bypass surgery
(3) death
Parameters for index:
(1) aortic valve disease
(2) angioplasty of the left main coronary artery
(3) shock
(4) recent myocardial infarction (within 24 hours before procedure)
(5) type C lesion
(6) multivessel coronary artery disease
(7) unstable angina
Protective factor:
(1) history of previous coronary artery bypass surgery (have a lower rate of requiring emergency bypass surgery)
predictive index =
= SUM(number of parameters present)
Interpretation:
• minimum index: 0
• maximum index: 7
• The higher the index the greater the risk for complications.
Predictive Index
Risk Group
Percent Complications
0
low
1.3%
1 or 2
moderate
2.8%
3
high
12.7%
4 or more
very high
29.7%
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