Risk Stratification and Interventional Cardiology: Robert L. Frye Lecture

Risk stratification and risk-benefit ratios are extremely important in guiding patient-physician interactions as well as patient and family counseling. Risks associated with percutaneous transluminal coronary angioplasty are (1) compromise of the vessel lumen or vessel integrity, (2) unsuccessful procedure, and (3) restenosis. Predicting mortality risk depends on the specific patient population to be treated and on the specific mortality model used. The most common models are those from New York State, the American College of Cardiology, the Northern New England Cooperative Group, the University of Michigan, and The Cleveland Clinic Foundation. As more data and sophisticated analyses become available, risk stratification will become more accurate as long as the approach used is straightforward, makes intuitive sense, and is easy and efficient to apply.