Document Detail


The Mayo Clinic Risk Score predicts in-hospital mortality following primary angioplasty.
MedLine Citation:
PMID:  16204745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Mayo Clinic Risk Score (MCRS) is a validated numeric score that predicts outcome following primary percutaneous coronary intervention (PCI). PURPOSE: We evaluated the ability of MCRS to risk stratify patients undergoing primary angioplasty. METHODS: Patients undergoing primary angioplasty within 6 hours of the onset of chest pain in the New York State percutaneous coronary intervention reporting system (n = 3,005) had their MCRS calculated using predictive variables: age, presence of cardiogenic shock, renal failure, class III-IV congestive heart failure, left main coronary disease and multivessel coronary disease. All patients were presumed to have intra-coronary thrombus and undergoing an urgent/emergent procedure. Based on the MCRS, patients were classified into five risk categories: very low-risk (MCRS < 5), low risk (6-8), moderate (9-11), high (12-14) and very high risk (15-25). RESULTS: The mean age of the study population was 62 years, 70% were male; stents were used in 89% and glycoprotein IIb/IIIa antagonists in 72%. The prevalence of cardiogenic shock, multivessel disease and left main disease was higher in patients with MCRS > 12. Overall in-hospital mortality following primary angioplasty was 4.7%; it was 0% in the very low-risk category, 0.9% in the low-risk category, 3.2% in the moderate-risk category, 10.7% in the high-risk category, and 25.1% in the very high-risk category (p < 0.0001). The higher-risk MCRS category predicted increased risk even when 317 (10.5%) patients with cardiogenic shock were excluded from the analysis. The overall c-statistic for the prediction of in-hospital mortality by MCRS was 0.85. CONCLUSION: Increasing MCRS predicts in-hospital mortality following primary angioplasty.
Authors:
Sridhar Sampath Kumar; Abdissa Negassa; E Scott Monrad; V S Srinivas
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  17     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-05     Completed Date:  2006-08-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  522-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / mortality*
Chest Pain
Chi-Square Distribution
Databases, Factual
Female
Heart Failure / epidemiology
Hospital Mortality*
Humans
Kidney Failure / epidemiology
Logistic Models
Male
Middle Aged
Myocardial Infarction / mortality*,  therapy
Prognosis
Risk Assessment*
Shock, Cardiogenic / epidemiology
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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