Mrdovic et al reported the RISK-PCI score for evaluating a patient undergoing percutaneous coronary intervention (PCI). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Belgrade.
Patient selection: PCI
Outome: 30-day major adverse cardiovascular events (MACE): death, nonfatal reinfarction, stroke
Parameters
(1) age
(2) history of prior infarction
(3) anterior infarction
(4) complete atrioventricular block on admission
(5) acute bundle branch block on admission
(6) WBC count in 10^9/L on admission
(7) blood glucose in mmol/L on admission
(8) creatinine clearance in mL per min on admission
(9) LVEF in percent
(10) infarction related artery (IRA) reference diameter in mm
(11) pre-procedure TIMI flow from 0 to 3
(12) post-procedure TIMI flow from 0 to 3
|
Parameter
|
Finding
|
Points
|
|
age in years
|
<= 75
|
0
|
|
|
> 75
|
1
|
|
prior infarct
|
no
|
0
|
|
|
yes
|
1.5
|
|
anterior AMI
|
no
|
0
|
|
|
yes
|
1
|
|
complete AV block
|
no
|
0
|
|
|
yes
|
2
|
|
acute BBB
|
no
|
0
|
|
|
yes
|
3.5
|
|
WBC count
|
<= 12 * 10^9/L
|
0
|
|
|
> 12 * 10^9/L
|
1
|
|
blood glucose
|
< 6.6 mmol/L
|
0
|
|
|
>= 6.6 mmol/L
|
1
|
|
creatinine clearance
|
>= 90 mL/min
|
0
|
|
|
60-89
|
1
|
|
|
< 60
|
2
|
|
LVEF
|
>=40%
|
0
|
|
|
< 40%
|
1.5
|
|
reference diameter
|
> 25 mm (? 2.5 mm)
|
0
|
|
|
<= 25 mm (?2.5 mm)
|
1
|
|
pre-PCI TIMI
|
>=1
|
0
|
|
|
0
|
1
|
|
post-PCI TIMI flow
|
3
|
0
|
|
|
< 3
|
3.5
|
where:
• A small artery had a reference diameter < 3 mm (page 225). A reference diameter of 25 mm would be an inch in diameter.
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the greater the risk of MACE.
X =
= (0.44782 * (score)) - 4.3902
probability of 30-day MACE =
= 1 / (1 + EXP((-1) * X))
