Echocardiographic parameters as predictors of in-hospital mortality in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
Different ways have been used to stratify risk in acute coronary syndrome (ACS) patients. The aim of the study was to examine the usefulness of echocardiographic parameters as predictors of in-hospital outcome in patients with ACS after percutaneous coronary intervention (PCI). A data of 2030 patients with diagnosis of ACS hospitalized from December 2008 to December 2011 was used to develop a risk model based on echocardiographic parameters using the binary logistic regression. This model was independently evaluated in validation cohort prospectively (954 patients admitted during 2012). In-hospital mortality in derivation cohort was 7.73%, and 6.28% in validation cohort. Developed model has been designed with 4 independent echocardiographic predictors of in-hospital mortality: left ventricular ejection fraction (LVEF RR = 0.892; 95%CI = 0.854-0.932, P < 0.0005), aortic leaflet separation diameter (AOvs RR = 0.131; 95%CI = 0.027-0.627, P = 0.011), right ventricle diameter (RV RR = 2.675; 95%CI = 1.109-6.448, P = 0.028) and right ventricle systolic pressure (RVSP RR = 1.036; 95%CI = 1.000-1.074, P = 0.048). Model has good prognostic accuracy (AUROC = 0.84) and it retains good (AUROC = 0.78) when testing on the validation cohort. Risks for in-hospital mortality after PCI in ACS patients using echocardiographic measurements could be accurately predicted in contemporary practice. Incorporation of such developed model should facilitate research, clinical decisions, and optimizing treatment strategy in selected high risk ACS patients.
Institute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, Serbia.
Miroslava
M
Sladojevic
Department for Telecommunications and Signal Processing, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovica 6, 21000 Novi Sad, Serbia.
Srdjan
0000-0002-9533-1210
S
Sladojevic
Department for Industrial Engineering and Management, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovica 6, 21000 Novi Sad, Serbia.
Dubravko
0000-0003-3417-1687
D
Culibrk
Institute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, Serbia.
Snezana
0000-0002-1652-0583
S
Tadic
Institute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, Serbia.
Robert
R
Jung
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D004452:Echocardiography; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008955:Models, Cardiovascular; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016896:Treatment Outcome