title: The Mayo Clinic Risk Score predicts in-hospital mortality following primary angioplasty.
abstract: BACKGROUND
  The Mayo Clinic Risk Score (MCRS) is a validated numeric score that predicts outcome following primary percutaneous coronary intervention (PCI).
  
  
  OBJECTIVE
  We evaluated the ability of MCRS to risk stratify patients undergoing primary angioplasty.
  
  
  METHODS
  Patients undergoing primary angioplasty within 6 hours of the onset of chest pain in the New York State percutaneous coronary intervention reporting system (n = 3,005) had their MCRS calculated using predictive variables: age, presence of cardiogenic shock, renal failure, class III-IV congestive heart failure, left main coronary disease and multivessel coronary disease. All patients were presumed to have intra-coronary thrombus and undergoing an urgent/emergent procedure. Based on the MCRS, patients were classified into five risk categories: very low-risk (MCRS < 5), low risk (6-8), moderate (9-11), high (12-14) and very high risk (15-25).
  
  
  RESULTS
  The mean age of the study population was 62 years, 70% were male; stents were used in 89% and glycoprotein IIb/IIIa antagonists in 72%. The prevalence of cardiogenic shock, multivessel disease and left main disease was higher in patients with MCRS > 12. Overall in-hospital mortality following primary angioplasty was 4.7%; it was 0% in the very low-risk category, 0.9% in the low-risk category, 3.2% in the moderate-risk category, 10.7% in the high-risk category, and 25.1% in the very high-risk category (p < 0.0001). The higher-risk MCRS category predicted increased risk even when 317 (10.5%) patients with cardiogenic shock were excluded from the analysis. The overall c-statistic for the prediction of in-hospital mortality by MCRS was 0.85.
  
  
  CONCLUSIONS
  Increasing MCRS predicts in-hospital mortality following primary angioplasty.
authors.affiliation: Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Sridhar Sampath
authors.initials: SS
authors.lastname: Kumar
authors.forename: Abdissa
authors.initials: A
authors.lastname: Negassa
authors.forename: E Scott
authors.initials: ES
authors.lastname: Monrad
authors.forename: V S
authors.initials: VS
authors.lastname: Srinivas
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D002637:Chest Pain; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D051437:Renal Insufficiency / Q000453:epidemiology; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000453:epidemiology; D013318:Stroke Volume