title: Angiographic Lesion Complexity Score and In-Hospital Outcomes after Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  We devised a percutaneous coronary intervention (PCI) scoring system based on angiographic lesion complexity and assessed its association with in-hospital complications.
  
  
  BACKGROUND
  Although PCI is finding increasing application in patients with coronary artery disease, lesion complexity can lead to in-hospital complications.
  
  
  METHODS
  Data from 3692 PCI patients were scored based on lesion complexity, defined by bifurcation, chronic total occlusion, type C, and left main lesion, along with acute thrombus in the presence of ST-segment elevation myocardial infarction (1 point assigned for each variable).
  
  
  RESULTS
  The patients' mean age was 67.5 +/- 10.8 years; 79.8% were male. About half of the patients (50.3%) presented with an acute coronary syndrome, and 2218 (60.1%) underwent PCI for at least one complex lesion. The patients in the higher-risk score groups were older (p < 0.001) and had present or previous heart failure (p = 0.02 and p = 0.01, respectively). Higher-risk score groups had significantly higher in-hospital event rates for death, heart failure, and cardiogenic shock (from 0 to 4 risk score; 1.7%, 4.5%, 6.3%, 7.1%, 40%, p < 0.001); bleeding with a hemoglobin decrease of >3.0 g/dL (3.1%, 11.0%, 13.1%, 10.3%, 28.6%, p < 0.001); and postoperative myocardial infarction (1.5%, 3.1%, 3.8%, 3.8%, 10%, p = 0.004), respectively. The association with adverse outcomes persisted after adjustment for known clinical predictors (odds ratio 1.72, p < 0.001).
  
  
  CONCLUSIONS
  The complexity score was cumulatively associated with in-hospital mortality and complication rate and could be used for event prediction in PCI patients.
authors.affiliation: Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Endo
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Kawamura
authors.affiliation: University of Tokyo, Healthcare Quality Assessment, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Miyata
authors.affiliation: Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Noma
authors.affiliation: Department of Cardiology, National Hospital Organization, Saitama National Hospital, Saitama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Kyosai Tachikawa Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Department of Cardiology, Saitama City Hospital, Saitama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Ishikawa
authors.affiliation: Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Department of Cardiology, Hiratsuka City Hospital, Kanagawa, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Takagi
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Tochigi, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Numasawa
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003710:Demography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome