Several factors affect the risk for a patient undergoing angioplasty of a coronary artery.
Parameters associated with risk:
(1) age
(2) gender
(3) number of vessels involved
(4) number of lesions
(5) history of congestive heart failure
(6) left ventricular ejection fraction
(7) angina
(8) degree of occlusion
(9) diabetes mellitus
(10) timing for PTCA
(11) antiplatelet therapy
(12) left main equivalent disease
|
Parameter |
low risk |
increased risk |
|
age |
< 70 years |
>= 70 |
|
gender |
male |
female |
|
number of vessels involved |
1 |
>= 2 |
|
number of lesions |
1 |
>= 2 |
|
history of CHF |
no |
yes |
|
left ventricular ejection fraction |
> 40% |
<= 40% |
|
angina |
none or stable |
unstable |
|
type of lesion |
A |
B or C |
|
degree of occlusion |
< 90% |
>= 90% |
|
diabetes mellitus |
no |
yes |
|
timing for PTCA |
|
immediately after thrombolytic therapy |
|
antiplatelet therapy |
adequate |
inadequate |
|
left main equivalent disease |
no |
yes |
where:
• Type A lesion = discrete, < 10 mm in length, readily accessible, concentric, in a nonangulated segment, smooth contour, little or no calcification, not totally occluded, no thrombus, no major side branch involvement, not ostial
Limitations:
• Experienced operators using newer technologies may be able to manage higher risk lesions.
• The risk assignment has low positive and negative predictive values.
Specialty: Cardiology
ICD-10: ,
