title: Comparison of prognostic risk scores after successful primary percutaneous coronary intervention.
abstract: BACKGROUND
  The aim of this study was to compare the predictive ability of clinical risk scores (ACEF, EuroSCORE and EuroSCORE II) to angiographic (SYNTAX score) and combined risk scores (Global Risk Score and Clinical SXscore) towards cardiovascular death and/or major adverse cardiac events (MACE) in patients with ST-segment elevation acute myocardial infarction (STEMI) managed with primary percutaneous coronary intervention (pPCI).
  
  
  METHODS
  A total of 685 patients successfully treated with pPCI were evaluated and the risk scores were calculated. The primary endpoint was the 2-year incidence of fatal cardiac events. Secondary end points were target lesion failure (TLF), repeat revascularization (RR) and MACE.
  
  
  RESULTS
  Patients distributed in the highest tertile of EuroSCORE II presented increased rates of CV death (CVD), all-cause mortality and MACE (p<0.001 for all). EuroSCORE II was associated with increased C-statistics (0.873, 95% CIs: 0.784-0.962 and 0.825, 95% CIs: 0.752-0.898 respectively) for predicting CVD and MACE over competing risk scores (p<0.05). EuroSCORE II conferred incremental discrimination (Harrell's C, p<0.05 for all, apart from CSS for predicting CVD) and reclassification value (Net Reclassification Index, p<0.05 for all, apart from CSS for reclassifying MACE) over alternative risk scores for study's main endpoints. EuroSCORE II independently predicted CVD (HR=1.06, 95% CIs: 1.03-1.09, p<0.001) and MACE (HR=1.07, 95% CIs: 1.04-1.10, p<0.001).
  
  
  CONCLUSIONS
  EuroSCORE II has the best predictive ability of CVD and/or MACE after successful pPCI for the treatment of STEMI.
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Synetos
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece. Electronic address: georgiopoulosgeorgios@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Georgiopoulos
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Voula
authors.initials: V
authors.lastname: Pylarinou
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Maniou
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Drakopoulou
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tolis
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Aggelos
authors.initials: A
authors.lastname: Papanikolaou
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Latsios
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiamis
authors.affiliation: First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: ACEF; EuroSCORE; EuroSCORE II; GRS; MACE; Primary percutaneous coronary intervention; SYNTAX score clinical SYNTAX score