Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in elderly patients undergoing multivessel PCI

详细信息    查看全文

• 作者：Jan-Malte Sinning (1)
  Tobias Asdonk (1)
  Christoph Erlhfer (1)
  Mariuca Vasa-Nicotera (1)
  Eberhard Grube (1)
  Georg Nickenig (1)
  Nikos Werner (1)
  
• 关键词：Elderly ; Multivessel PCI ; SYNTAX score ; EuroSCORE ; Outcome ; Coronary artery disease
• 刊名：Clinical Research in Cardiology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：102
• 期：12
• 页码：865-873
• 全文大小：
• 作者单位：Jan-Malte Sinning (1)
  Tobias Asdonk (1)
  Christoph Erlhfer (1)
  Mariuca Vasa-Nicotera (1)
  Eberhard Grube (1)
  Georg Nickenig (1)
  Nikos Werner (1)
  
  1. Department of Medicine II, Heart Center Bonn, University Hopsital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
  
• ISSN：1861-0692

文摘

Background Risk stratification is essential for the clinical decision-making process in elderly patients undergoing multivessel revascularization, since the optimal revascularization strategy remains subject of ongoing debate. Aims To assess the prognostic value of angiographic versus clinical characteristics for the prediction of a first adverse cardiac and cerebrovascular events (MACCE) (all-cause mortality, non-fatal myocardial infarction, stroke, and target lesion revascularization) and to develop a combined risk model. Methods After multivessel percutaneous coronary intervention (MV-PCI), SYNTAX score and EuroSCORE were calculated as combined risk model in 328 elderly patients who were followed up for a first MACCE. Results 328 patients with a mean age of 77.55.1years were followed up for 2.71.5years. A first MACCE occurred in 50.0% (164/328) of the patients. To improve predictability, a combined risk score model with receiver operating characteristic curve validated cut-off values for EuroSCORE (>5%) and SYNTAX score (>25) was developed. High risk patients had a 3.5-fold higher risk for MACCE after 3years (HR 7.1, 95% CI 1.9.5; p<0.001). Conclusions For adequate risk assessment in elderly patients undergoing MV-PCI, consideration of both comorbidities and coronary anatomic complexity is essential. A combined angiographic and clinical risk score provides superior prediction of 3-year MACCE risk in elderly patients.