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CADILLAC Risk Score of Halkin et al for Predicting 1 Year Mortality Following Percutaneous Coronary Intervention (PCI) for an Acute Myocardial Infarction

Purpose: To predict 1 year mortality for a patient undergoing a percutaneous cutaneous intervention (PCI) following an acute myocardial infarction.

Description

Halkin et al developed a risk score for predicting 1 year mortality following a percutaneous coronary intervention (PCI) in a patient with an acute myocardial infarction based on the CADILLAC Study. The authors are from multiple hospitals in the United States and Spain.


CADILLAC = controlled abciximab and device investigation to lower late angioplasty complications

 

Parameters from multivariate analysis:

(1) baseline left ventricular ejection fraction (LVEF)

(2) renal function

(3) Killip class

(4) final TIMI flow rate

(5) age in years

(6) anemia

(7) extent of coronary artery disease

 

Parameter

Finding

Points

baseline LVEF

>= 40%

0

 

< 40%

4

renal function

normal

0

 

insufficiency

3

Killip class

no heart failure (Killip 1)

0

 

heart failure (Killip 2 or 3) without cardiogenic shock

3

final TIMI flow

TIMI 3 (complete perfusion)

0

 

TIMI 0 to 2 (none to partial perfusion)

2

age in years

<= 65 years

0

 

> 65 years

2

anemia

absent

0

 

present

2

extent of coronary artery disease

1 or 2 arteries

0

 

3 vessel disease

2

 

where:

• Patients with Killip class 4 (cardiogenic shock) are not included.

• 3 vessel disease may include more vessels as well (unless these went to CABG).

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 18

• The higher the score the greater the risk of 1 year mortality.

 

Total Score

Probability of 1 Year Mortality

0 or 2

0 - 1.2%

3

2.5%

4 or 5

4 - 5%

6 to 8

7 - 8%

9

15%

10 to 12

25 to 30%

13 to 18

50%

 


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Specialty

Objective

ICD-10