Predicted and observed in-hospital mortality after left main coronary artery stenting in 204 patients.
BACKGROUND
The purpose of this study was to compare risk predicted using available risk scores and actual outcomes in patients with left main coronary artery disease undergoing percutaneous coronary intervention with stent implantation (PCI LM).


METHODS
We studied 204 patients treated with elective or emergent coronary angioplasty. We estimated in-hospital mortality using the EuroSCORE, Parsonnet and GRACE risk scores and compared this data with actual in-hospital mortality.


RESULTS
There were no deaths among 62 patients undergoing elective PCI LM regardless of the estimated risk. Acute coronary syndrome (ACS) was diagnosed in all 142 patients undergoing emergent PCI LM. Mortality in this group was 24% (34/142). Area under receiver operating characteristic curve (AUC) values for the EuroSCORE, Parsonnet and GRACE risk scores in patients with ACS were 0.812 (p = 0.0001), 0.857 (p = 0.0001), and 0.870 (p = 0.0001), respectively. No statistically significant differences were found when these AUC values for different evaluated risk scores were compared. Overall, the EuroSCORE and Parsonnet risk scores had no discriminative value, as all deaths occurred in the highest risk group. Only the GRACE risk score discriminated risk among intermediate- and high-risk patients with ACS.


CONCLUSIONS
The EuroSCORE and Parsonnet scoring systems are of no value in predicting periprocedural mortality risk in patients undergoing elective PCI LM. Overall, discriminative ability of the EuroSCORE, Parsonnet, and GRACE risk scores in unselected patients with ACS undergoing emergent PCI LM was good. In this group of patients, the EuroSCORE and Parsonnet scoring systems had no discriminative value in low and moderate risk patients. Only the GRACE risk score discriminated risk among intermediate and high risk patients.
Sukiennik
Adam
A
Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Toruń, Poland. adamsuk@cm.umk.pl
Ostrowska-Nowak
Joanna
J
Wiśniewska-Szmyt
Joanna
J
Radomski
Marek
M
Rychter
Marcin
M
Jabłoński
Mirosław
M
Białoszyński
Tomasz
T
Koziński
Marek
M
Fabiszak
Tomasz
T
Dobosiewicz
Ryszard
R
Zabielska
Ewa
E
Sukiennik
Tamara
T
Kubica
Aldona
A
Król
Anna
A
Demidowicz
Krzysztof
K
Chojnicki
Maciej
M
Grabczewska
Zofia
Z
Swiatkiewicz
Iwona
I
Bogdan
Maria
M
Grześk
Grzegorz
G
Kubica
Jacek
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome