Correlates of procedural complications and a simple integer risk score for percutaneous coronary intervention.
OBJECTIVE
Our goals were to identify clinical and angiographic risk factors associated with major cardiovascular complications of percutaneous coronary intervention (PCI) (in-hospital death, Q-wave myocardial infarction, urgent or emergent coronary artery bypass surgery and stroke) and to construct a simple score for risk stratification.


BACKGROUND
Both clinical and angiographic features influence risk of PCIs.


METHODS
Percutaneous coronary interventions performed between January 1, 1996, and December 31, 1999, were analyzed. Logistic regression and bootstrap methods were used to create an integer risk score for estimating the risk of procedural complications using baseline, angiographic and procedural characteristics. The risk score was tested in a validation-set consisting of all procedures performed in the year 2000.


RESULTS
Among 5,463 procedures, 5 clinical and 3 angiographic variables were significantly correlated with procedural complications: cardiogenic shock, left main coronary artery disease, severe renal disease, urgent or emergent procedure, congestive heart failure class III or higher, thrombus, multivessel disease and older age. In the validation-set, the model fitted the data adequately; the average receiver operating characteristic curve area was 0.782 (standard deviation, 0.018).


CONCLUSIONS
Eight variables were combined into a convenient bedside risk scoring system that estimates the risk of complications after PCIs.
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
Mandeep
M
Singh
Ryan J
RJ
Lennon
David R
DR
Holmes
Malcolm R
MR
Bell
Charanjit S
CS
Rihal
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D015995:Prevalence; D012372:ROC Curve; D011859:Radiography; D012307:Risk Factors; D013223:Statistics as Topic; D017211:Treatment Failure