Validation of a risk score for target vessel revascularization after coronary stent implantation.
OBJECTIVE
Our aim was to validate a risk score for new target vessel revascularization (TVR) after bare-metal stent (BMS) implantation.


METHODS
The risk score was developed in a cohort of patients previously treated with BMS at our institution. This risk score ranges from 0 to 5 points, according to the presence of diabetes mellitus (1 point), reference vessel diameter (> 3.5 mm = 0 points; 3-3.5 mm = 1; < 3 mm = 2) and lesion length (< or = 10 mm = 0 points; 10-20 mm = 1; > 20 mm = 2). Patients included in the validation cohort were treated between January and December 2005. Patient characteristics and 1-year clinical follow up were prospectively recorded into a dedicated database. A new coronary angiography was performed only when recurrent ischemia was suspected.


RESULTS
The mean age of the 491 patients included was 61 +/- 10.5 years, and 35% were women. Diabetes mellitus was present in 22%, a previous percutaneous coronary intervention in 12% and previous myocardial infarction in 35%. The mean reference vessel diameter was 2.80 +/- 0.56 mm and the mean lesion length was 12.45 +/- 6.3 mm. The overall 1-year TVR rate was 13.9%. TVR rates increased with each score level: Score = 0, TVR = 0% (n = 16); Score 1 = 5.3% (n = 48); Score 2 = 12% (n = 170); Score 3 = 14% (n = 146); and Score 4/5 = 25% (n = 54); (p = 0.008).


CONCLUSIONS
The risk score was significantly associated with TVR rates and can be used as a simple clinical tool to identify those patients at a low risk for a new revascularization procedure.
Quadros
Alexandre S
AS
Institute of Cardiology of Rio do Sul/University Cardiology Foundation, Porto Alegre, RS, Brazil. editoracao-pc@cardiologia.org.br
Diemer
Fabiane
F
Welter
Dulce
D
Modkovski
Thais
T
Sarmento-Leite
Rogério
R
Gottschall
Carlos A M
CA
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology*; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D018570:Risk Assessment / Q000379:methods; D015607:Stents