Comparison of prognostic risk scores after successful primary percutaneous coronary intervention

详细信息    查看全文

• 作者：Andreas Synetos¹ ; George Georgiopoulos ; ¹ ; ^{georgiopoulosgeorgios@gmail.com} ; Voula Pylarinou¹ ; Konstantinos Toutouzas ; Katerina Maniou ; Maria Drakopoulou ; Panagiotis Tolis ; Antonios Karanasos ; Aggelos Papanikolaou ; George Latsios ; Eleftherios Tsiamis ; Dimitrios Tousoulis
• 关键词：Primary percutaneous coronary intervention ; MACE ; SYNTAX score clinical SYNTAX score ; ACEF ; GRS ; EuroSCORE ; EuroSCORE II
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：482-487
• 全文大小：483 K
• 卷排序：230

文摘

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).MethodsA 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.ResultsPatients 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).ConclusionEuroSCORE II has the best predictive ability of CVD and/or MACE after successful pPCI for the treatment of STEMI.