Singh et al reported a new versions of a risk score for patients undergoing percutaneous coronary intervention (PCI). One score was predictive of major adverse cardiovascular events. The authors are from the Mayo Clinic in Rochester.
Patient selection: PCI
Outcome: major adverse cardiovascular events (MACE) - in-hospital death, Q-waave AMI, urgent or emergent CABG, or stroke during hospitalization
Parameters:
(1) age in years
(2) serum creatinine in mg/dL
(3) left ventricular ejection fraction in percent
(4) preprocedural cardiogenic shock
(5) myocardial infarction <= 24 hours
(6) CHF on presentation (without AMI or shock)
(7) peripheral artery disease
|
Parameter |
Finding |
Points |
|
age in years |
< 36.5 |
3 |
|
|
36.5 to 44 |
2 |
|
|
44 to 50.5 |
1 |
|
|
50.5 to 64 |
0 |
|
|
64 to 68.5 |
1 |
|
|
68.5 to 72.5 |
2 |
|
|
72.5 to 77.5 |
3 |
|
|
77.5 to 81.5 |
4 |
|
|
81.5 to 87.5 |
5 |
|
|
> 87.5 |
6 |
|
serum creatinine |
< 0.55 |
2 |
|
|
0.55 to 0.8 |
1 |
|
|
0.8 to 1.3 |
0 |
|
|
1.3 to 1.4 |
1 |
|
|
1.4 to 3.8 |
2 |
|
|
> 3.8 |
3 |
|
LVEF |
>39.5 |
0 |
|
|
23 to 39.5 |
1 |
|
|
< 23 |
2 |
|
cardiogenic shock |
no |
0 |
|
|
yes |
9 |
|
AMI <= 24 hours |
no |
0 |
|
|
yes |
2 |
|
CHF on presentation |
no |
0 |
|
|
yes |
2 |
|
peripheral artery disease |
no |
0 |
|
|
yes |
2 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 25 (23 if CHF is counted if neither shock nor AMI present, as for in-hospital mortality).
log(odds ratio for MACE) =
= (0.228 * (score)) - 4.45
|
Score |
Risk Category |
|
0 to 2 |
very low |
|
3 to 5 |
low |
|
6 to 9 |
moderate |
|
10 to 13 |
high |
|
>= 14 |
very high |
Specialty: Cardiology
