| Combination of angiographic and clinical characteristics for the prediction of clinical outcomes in patients undergoing unprotected left main coronary artery stenting. | |
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MedLine Citation:
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PMID: 22286320 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Risk stratification is essential for the clinical decision-making process in patients undergoing revascularization of the unprotected left main coronary artery (ULMCA), since the optimal revascularization strategy still remains subject of ongoing debate. OBJECTIVES: To assess the prognostic value of angiographic versus clinical characteristics for the prediction of major adverse cardiac events (MACE) and to develop a combined risk model. METHODS: In 115 patients, who were followed up for MACE after ULMCA stenting, SYNTAX score and EuroSCORE have been calculated for a combined risk model. RESULTS: Whereas the SYNTAX score was not able to predict MACE at 1 year (32.8 ± 11.7 vs. 29.1 ± 12.2, P = 0.13), the logistic EuroSCORE was significantly increased in these patients suffering a MACE at 1 year [11.9 (4.4/22.6) vs. 4.8 (2.3/14.6)%, P = 0.007]. With ROC curve validated cut-off values, the combination of EuroSCORE (>7.5%) and SYNTAX score (>25) provided incremental predictive value for risk stratification of ULMCA patients (AUC 0.71, 95% CI 0.62-0.79, P < 0.001). This combined risk model was associated with the rate of cardiac mortality (P = 0.04), non-fatal myocardial infarction (P = 0.005), and target lesion revascularization (P = 0.04) and was superior to the SYNTAX score alone (P = 0.03). High risk patients had a 7.1-fold higher risk for MACE (HR 7.1. 95% CI 2.1-24.1, P = 0.002) after 1 year. CONCLUSIONS: For adequate risk assessment in ULMCA patients, consideration of both comorbidities and coronary anatomic complexity, is essential. A combination of angiographic and clinical risk scores improves the prognostic value for the prediction of 1-year MACE risk and is superior to stand-alone scores. |
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Authors:
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Jan-Malte Sinning; Viktoria Stoffel; Eberhard Grube; Georg Nickenig; Nikos Werner |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-28 |
Journal Detail:
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Title: Clinical research in cardiology : official journal of the German Cardiac Society Volume: - ISSN: 1861-0692 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101264123 Medline TA: Clin Res Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität, Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany. |
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