Predicting 30-day major adverse cardiovascular events after primary percutaneous coronary intervention. The RISK-PCI score

Mrdović, Igor; Savić, Lidija; Krljanać, Gordana; Ašanin, Milika; Peruničić, Jovan; Lasica, Ratko; Marinković, Jelena; Kocev, Nikola; Vasiljević, Zorana; Ostojić, Miodrag

doi:10.1016/j.ijcard.2011.05.071

Cited by 30 publications

(47 citation statements)

References 31 publications

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“…with advanced age increases the risk of early adverse outcomes in patients treated by pPCI, which is consistent with literature data [7,8,12]. Studies dealing with risk assessment and adverse events aft er pPCI using scoring systems [13][14][15][16] give age a signifi cant impact as predictor of early adverse outcome, which was confi rmed in a meta-analysis that dealt with the comparison of these studies [16]. On the other hand Teplitsky et al analysis showed that in patients older than 90 years, pPCI was associated with low mortality in clinically stable patients, while clinically unstable patients had much worse prognosis in a six-month followup [17].…”

Section: Discussionsupporting

confidence: 85%

“…In patients with diabetes, higher serum glucose level is associated with adverse prognosis and a higher mortality rate [7,8,14,15,[19][20][21][22][23][24]. In patients who were not suff ering from diabetes has been shown that high glucose level on admission has a signifi cant role as an independent predictive factor for early and late prognosis [21].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and laboratory predictors of early mortality in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Ruzicic¹,

Ruzicic²,

Mrdovic³

2016

Hosp Pharm Int Multi J

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SUMMARYIntroduction: Primary percutaneous coronary intervention (pPCI) has become the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI). Previous research studies have shown that certain clinical and laboratory parameters can be associated with early mortality in patients with acute myocardial infarction treated by primary PCI. The Aim: The aim of our study was to determine the clinical and laboratory predictors of an adverse early prognosis of our patients with STEMI treated by primary PCI. Material and Methods:The population of our IV phase, academic, observational, retrospective cross-sectional study comprises a total of 180 consecutive patients, 128 men and 52 women, aged 18, or older, who presented with clinical and electrocardiographic signs of acute STEMI within 12 hours after symptom onset. We analyzed the parameters which were registered in the database system of the Coronary Unit of Emergency Center. Results: The average age of the surviving patients was 58±11, and 67±9 in the deceased patient group but the correlation was not statistically signifi cant (p=0.075). The group of patients who didn't survive had signifi cantly more hypotension on admission (p=0.015), acute bundle branch block on ECG (p=0.032), higher creatinine on admission (p=0.036), patient history of hyperlipidaemia (p=0.044), creatinine clearance below 60ccs/min (p<0.001), Killip>1 heart failure on admission (p=0.038), but this group contained a signifi cantly lower number of smokers (p=0.021). Predictors of an adverse early event in multivariant analysis were: acute bundle branch block, diabetes, Killip> 1 on admission, hypotension on admission, creatinine clearance below 60ccs/min. Conclusions: Our study indicates that acute bundle branch block, diabetes, Killip>1 heart failure on admission, hypotension on admission, creatinine clearence below 60ccs/min, are independent clinical and laboratory predictors of early mortality in patients with STEMI treated by primary PCI.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory predictors of early mortality in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Ruzicic¹,

Ruzicic²,

Mrdovic³

2016

Hosp Pharm Int Multi J

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“…17 For the 1-year MI models, we used covariates based on clinical reasoning and previous studies. [18][19][20] Covariates included age, sex, race, ethnicity, diabetes mellitus, dyslipidemia, hypertension, renal failure, cerebrovascular disease, peripheral arterial disease, body weight, chronic obstructive pulmonary disorder, smoking, and previous MI. A robust estimator of the covariance matrix was used to account for clustering by site.…”

Section: Discussionmentioning

confidence: 99%

Patient Access and 1-Year Outcomes of Percutaneous Coronary Intervention Facilities With and Without On-Site Cardiothoracic Surgery

et al. 2014

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The US Department of Veterans Affairs (VA) has the largest integrated health care delivery system in the nation and serves a large number of veterans living in rural locations. In an effort to improve patients' access to cardiology services, the VA began offering PCI programs at facilities without on-site CT surgery in 2005, coupled with strict quality oversight. Specifically, it established a national clinical quality oversight program-the Clinical Assessment, Reporting, and Tracking (CART) Program-for all VA cath labs that collected real-time data on cath laboratory Background-The safety of percutaneous coronary intervention (PCI) at medical facilities without on-site cardiothoracic (CT) surgery has been established in clinical trials. However, the comparative effectiveness of this strategy in real-world practice, including impact on patient access and outcomes, is uncertain. The Veterans Affairs (VA) health care system has used this strategy, with strict quality oversight, since 2005, and can provide insight into this question. Methods and Results-Among 24 387 patients receiving PCI at VA facilities between October 2007 and September 2010, 6616 (27.1%) patients underwent PCI at facilities (n=18) without on-site CT surgery. Patient drive time (as a proxy for access), procedural complications, 1-year mortality, myocardial infarction, and rates of subsequent revascularization procedures were compared by facility. Results were stratified by procedural indication (ST-segment-elevation myocardial infarction versus non-ST-segment-elevation myocardial infarction/unstable angina versus elective) and PCI volume. With the inclusion of PCI facilities without on-site CT surgery, median drive time for patients treated at those facilities decreased by 90.8 minutes (P<0.001). Procedural need for emergent coronary artery bypass graft and mortality rates were low and similar between facilities. Adjusted 1-year mortality and myocardial infarction rates were similar between facilities (hazard ratio in PCI facilities without relative to those with on-site CT surgery, 1.02; 95% confidence interval, 0.87-1.2), and not modified by either PCI indication or PCI volume. Subsequent revascularization rates were higher at sites without on-site CT surgery facilities (hazard ratio, 1.21; 95% confidence interval, 1.03-1.42). Conclusions-This study suggests that providing PCI facilities without on-site CT surgery in an integrated health care system with quality oversight improves patient access without compromising procedural or 1-year outcomes.

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“…Osim toga pokazalo se da se možemo osoniti na SYNTAX skor kada je u pitanju predikcija ishoda kod pacijenata sa trosudov nom bolešću lečenih PCI [5]. RISKPCI skor, sa druge strane, jeste klinički skor koji na osnovu 12 nezavisnih prediktora omogućava stratifikaciju tridesetodnevnog, ali i jednogodišnjeg rizika za pojavu ozbiljnih neželjenih kardiovaskularnih događaja (major adverse cardiovascular events-MACE) [6]. RISKPCI skor i njegove modifik acije pokazale su se relevantnim u predikciji kompliko vanih krvarenja i trombotske okluzije stenta posle PCI [7,8].…”

Section: Uvodunclassified

“…Time je smanjena interobzerverska varijabilnost koja predstavlja značajan problem pri izračunavanju SYNTAX skora [9]. RISKPCI skor je noviji i samim tim manje istražen skor u odnosu na SYNTAX, ali je njegova vrednost ustanovljena na reprezentativnom uzorku paci jenata u RISKPCI studiji, kao i iz nje proisteklim stu dijama [6]. Visoko statistički značajna korelacija koju smo dobili u rezultatima ove studije potvrđuje predik tivnu vrednost oba skora i omogućava uspostavljanje veze između njih.…”

Section: Medical Youthunclassified

Korelacija RISK-PCI i syntax skora rizika kod bolesnika sa STEMI i njihov prognosticki znacaj

Vorkapić¹

2015

Med podmladak

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SažetakUvod: STEMI je jedan od vodećih uzroka smrti u opštoj populaciji. Radi odabira optimalne tera pije za STEMI bolesnike napravljeni su brojni klinički i anatomski skorovi rizika. U dosadašnjim studijama SYNTAX skor je korišćen kao anatomski skor rizika ba ziran na angiografskom nalazu dok je RISKPCI prven stveno klinički skor.Cilj rada je da analizira postojanje i nivo korelaci je između SYNTAX i RISKPCI skora kao i da odredi u kojoj meri se možemo osloniti na njih u proceni progno ze i ishoda bolesti kod bolesnika sa STEMI.Materijali i metode: Oba skora kao i klinički tok bolesti pratili smo kod konsekutivno lečenih bolesnika starijih od 18 godina koji su se prezentovali sa simpto mima i znacima STEMI. Pacijenti su lečeni primarnom PCI i hospitalizovani u Koronarnoj jedinici (KJ) Klini ke za kardiologiju KCS u periodu od avgusta 2014. do januara 2015. godine. Za određivanje SYNTAX skora koristili smo online softver: "SYNTAX score calculator", a za određivanje RISKPCI skora kalkulator na sajtu Udruženja koronarnih jedinica Srbije. U obradi poda taka koristili smo statistički program SPSS (IBM SPSS version 19).Rezultati: Ukupno je u studiju uključeno 42 STEMI bolesnika. Prosečne godine starosti pacijenata su 57,4 ± 10,6 godina, muškarci/žene 79/21%. U našoj analizi dobili smo statistički visoko značajnu korelaciju SYNTAX i RISKPCI skora R = 0,641, p = 0,01.Zaključak: Između dva široko primenjena skora rizika kod bolesnika sa infarktom miokarda sa ST eleva ciom (STEMI) postoji visoko značajna korelacija. To bi moglo da bude od velike važnosti, jer ukazuje na to da se dalja prognoza i ishod bolesnika sa STEMI može na adekvatan način predvideti na osnovu oba skora rizika.Ključne reči: pPCI, STEMI, SYNTAX score, RISKPCI score. AbstractIntroduction: Myocardial infarction with ST ele vation (STEMI) is a leading cause of death in the gener al population. In order to select the optimal therapy for STEMI patients many clinical and anatomic risk scores were calculated. In previous studies SYNTAX score was used as an anatomical risk score based on angiographic findings while RISKPCI is primarily a clinical score.The aim of this study is to analyze the existence and level of correlation between SYNTAX and RISKPCI scores and to determine the extent to which we can rely on them in the assessment of prognosis and outcome of patients with STEMI.Materials and Methods: Both scores and the clin ical course of the disease were analysed in consecutive patients over 18 years of age that presented with symp toms and signs of STEMI. All patients received primary PCI and were hospitalized in the coronary care unit of the cardiology clinic, Clinical center of Serbia in the pe riod of August 2014 January 2015. The online software "SYNTAX score calculator" was used for determining the SYNTAX score and the United coronary care units of Serbia online software was used for the determination of RISKPCI score. SPSS (IBM SPSS version 19) software was used for the statistical analysis of data.Results: In total, the study included 42 STEMI pa ...

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Predicting 30-day major adverse cardiovascular events after primary percutaneous coronary intervention. The RISK-PCI score

Cited by 30 publications

References 31 publications

Clinical and laboratory predictors of early mortality in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Clinical and laboratory predictors of early mortality in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Patient Access and 1-Year Outcomes of Percutaneous Coronary Intervention Facilities With and Without On-Site Cardiothoracic Surgery

Korelacija RISK-PCI i syntax skora rizika kod bolesnika sa STEMI i njihov prognosticki znacaj

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