Bedside estimation of risk from percutaneous coronary intervention: The new Mayo Clinic risk scores

Mandeep Singh, Charanjit Rihal, Ryan J. Lennon, John Spertus, John S. Rumsfeld, David Holmes

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To derive risk models for percutaneous coronary intervention (PCI) outcomes from clinical and laboratory variables available before the procedure so they can be used for preprocedure risk stratification. PATIENTS AND METHODS: Using the Mayo Clinic registry, we analyzed 9035 PCIs on 7640 unique patients from January 1, 2000, through April 30, 2006. We Included only the first PCI per patient (n=7467). Logistic regression was used to model the calculated risk score and major procedural complications, separate risk models were made for mortality and major adverse cardiovascular events (MACE) derived solely from baseline and laboratory characteristics. Final risk scores for procedural death, defined as any death during the index hospitalization, and MACE contained the same 7 variables (age, myocardial infarction ≤24 hours, preprocedural shock, serum creatinine level, left ventricular ejection fraction, congestive heart failure, and peripheral artery disease). RESULTS: Models had adequate goodness of fit, and areas under the receiver operating characteristic curve were 0.74 and 0.89 for MACE and procedural death, respectively, indicating excellent overall discrimination. The model was robust across many subgroups, Including those undergoing elective PCI, those having diabetes mellitus, and elderly patients. Bootstrap analysis Indicated that the model was not overfit to the available data set. CONCLUSIONS: Before coronary angiography tat performed, a risk-scoring system based on 7 variables can be used conveniently to predict cardiovascular complications after PCI. This model may be useful for providing pattante with individualized, evidence-based. estimates of procedural risk as part of the informed consent process.

Original languageEnglish (US)
Pages (from-to)701-708
Number of pages8
JournalMayo Clinic Proceedings
Volume82
Issue number6
DOIs
StatePublished - 2007

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Percutaneous Coronary Intervention
Peripheral Arterial Disease
Coronary Angiography
Informed Consent
ROC Curve
Stroke Volume
Registries
Shock
Creatinine
Diabetes Mellitus
Hospitalization
Heart Failure
Logistic Models
Myocardial Infarction
Mortality
Serum

ASJC Scopus subject areas

  • Medicine(all)

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Bedside estimation of risk from percutaneous coronary intervention : The new Mayo Clinic risk scores. / Singh, Mandeep; Rihal, Charanjit; Lennon, Ryan J.; Spertus, John; Rumsfeld, John S.; Holmes, David.

In: Mayo Clinic Proceedings, Vol. 82, No. 6, 2007, p. 701-708.

Research output: Contribution to journalArticle

Singh, Mandeep ; Rihal, Charanjit ; Lennon, Ryan J. ; Spertus, John ; Rumsfeld, John S. ; Holmes, David. / Bedside estimation of risk from percutaneous coronary intervention : The new Mayo Clinic risk scores. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 6. pp. 701-708.
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