Brener et al reported a score for predicting risk of 30-day mortality after percutaneous coronary intervention (PCI). The authors are from multiple institutions in the United States and Europe.
Patient selection: percutaneous coronary intervention (PCI)
Outcome: 30-day mortality
Parameters:
(1) age in years
(2) TIMI flow before PCI (from 0 to 3)
(3) TIMI flow after PCI
(4) acute coronary syndrome (ACS) presentation
(5) prior myocardial infarction
(6) first generation drug-eluting stent (DES) used
(7) diabetes mellitus
(8) left main or left anterior descending lesion treated
Parameter
Finding
Points
age in years
< 55
0
55-75
2
> 75
4
TIMI flow before PCI
> 1
0
0-1
3
TIMI flow after PCI
3
0
< 3
3
ACS presentation
no
0
yes
2
prior myocardial infarct
no
0
yes
1
first generation DES
no
0
yes
1
diabetes mellitus
no
0
yes
1
LM or LAD lesion treated
no
0
yes
1
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• A score >= 5 is associated with a 30-day mortality of 86%.
• A score < 5 has a 30-day mortality of 8%.
Performance:
• The area under the ROC curve is 0.83-0.85.
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