### Description

Madan et al developed a score for predicting the risk of adverse events following a percutaneous coronary intervention (PCI). This can help to identify the high risk patient who may benefit from a novel or aggressive management strategy. The authors are from the Texas Heart Institute at St. Luke's Episcopal Hospital in Houston.

Outcome: one or more adverse events (mortality within 30 days, repeat PCI during the same admission, acute myocardial infarction, need for coronary artery bypass graft (CABG) surgery, cerebrovascular accident)

Parameters:

(1) unstable angina

(2) renal insufficiency

(3) hypertension

(4) acute myocardial infarction

(5) congestive heart failure (CHF)

(6) peripheral vascular disease

(7) timing of the PCI (elective, urgent, emergent)

(8) thrombus

(9) Type C lesion

(10) number of stents placed

 Parameter Finding Points unstable angina absent 0 present 5 renal insufficiency absent 0 present 4 hypertension absent 0 present 3 acute myocardial infarction absent 0 present 4 congestive heart failure absent 0 present 4 peripheral vascular disease absent 0 present 3 timing of the PCI elective 0 urgent 9 emergent 14 thrombus absent 0 present 4 Type C lesion absent 0 present 4 number of stents placed 0 or 1 0 2 4 3 or more 5

total score =

= SUM(points for all 10 parameters)

Interpretation:

• minimum score: 0

• maximum score: 50 or 54 or 64 (50 is the maximum score based on the above scoring; 54 is the maximum score plotted in Figure 1; 64 is the maximum score plotted in Figure 2).

• The higher the score the greater the risk for an adverse event.

 Total Score Risk of an Adverse Event 0 to 9 low (<= 2%) 10 to 19 intermediate (2.2 to 5%) 20 or more high (> 5%)

 Score Probability 0 to 16 (0.2115 * (score)) + 0.1028 16 to 37 (0.03267 * ((score)^2)) - (0.8142 * (score)) + 8.437 37 to 64 (-0.009175 * ((score)^2)) + (3.176 * (score)) - 82.55