The Cadillac Risk Score Accurately Identifies Patients at Low Risk for In-Hospital Mortality and Adverse Cardiovascularevents Following St Elevation Myocardial Infarction.

Abstract

Background: The CADILLAC risk score was developed to identify patients at low risk for adverse cardiovascular events following ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods: We performed a single center retrospective review of STEMI hospitalizations treated with PPCI from 2014 to 2018. Patients were stratified using the CADILLAC risk score into low risk group versus intermediate to high risk group. Patients presenting with cardiac arrest or cardiogenic shock were excluded from the study. The primary outcome was adverse clinical events during initial hospitalization. Secondary outcomes were adverse clinical events at 30 days and 1 year following index hospitalization. Results: The study included 314 patients. It was found that patients with a low CADILLAC score had significantly lower adverse clinical events compared to the intermediate-high CADILLAC score group (10/213 (4.7%) vs. 15/128 (11.7%), odds ratio = 0.37, 95% CI 0.16-0.85, p= 0.028). Additionally, patients with a low CADILLAC score had significantly lower adverse clinical event rates at 30 day and 1 year follow up. The mortality rate was 0% for patients defined at low risk by CADILLAC score during hospitalization, as well up to 1 year follow up. ROC curve predicting in hospital event rate showed CADILLAC (C=0.66, odds ratio 1.18; 95% CI 1.04 - 1.33; p=0.0064). Conclusion: Patients defined as low risk by the CADILLAC score following a STEMI were associated with lower event rates when compared to those with an intermediate-high CADILLAC score.