Evaluation of comorbidity scores to predict all-cause mortality in patients with established coronary artery disease

Chirinos, Julio A.; Veerani, Anila; Zambrano, Juan P.; Schob, Alan; Pérez, Guido O.; Mendez, Armando J.; Chakko, Simon

doi:10.1016/j.ijcard.2006.06.005

Cited by 27 publications

(15 citation statements)

References 22 publications

(17 reference statements)

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“…The high prevalence of comorbidities in our cohort is consistent with the published literature and could have contributed to the observed mortality in our population, which was 38% for the total cohort at 6 months after hospital discharge. The prognostic importance of comorbidities for short-and long-term survival in cardiology patients and patients with coronary artery disease has previously been shown [34][35][36], suggesting that coexisting illnesses should be taken into account for quality comparisons in clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Argyriou

Vrettou

Filippatos

et al. 2015

Journal of Critical Care

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Section: Discussionmentioning

confidence: 99%

Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Argyriou

Vrettou

Filippatos

et al. 2015

Journal of Critical Care

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“…The Charlson index, comprising 12 chronic conditions and, more recently, the CAD-specific index are common examples of the instruments available for more systematic and comprehensive inclusion of comorbid conditions into risk prediction models. Both models provide powerful tools to predict all-cause mortality 14. For this study, we chose the latter because it was developed and designed from data on patients with documented CAD 4 15.…”

Section: Discussionmentioning

confidence: 99%

Comorbid conditions and outcomes after percutaneous coronary intervention

Singh

Rihal

Roger

et al. 2008

Heart

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Results: The mean (SD) MCRS score was 6.5 (2.9). The CAD-specific index was 0 or 1 in 46%, 2 or 3 in 30% and 4 or higher in 24%. The rate of in-hospital major adverse cardiovascular events (MACE) increased with higher MCRS and CAD-specific index (Cochran-Armitage test, p,0.001 for both models). The c-statistic for the MCRS for in-hospital MACE was 0.78; adding the CAD-specific index did not improve its discriminatory ability for inhospital MACE (c-statistic = 0.78; likelihood ratio test, p = 0.29). A total of 707 deaths after dismissal occurred after 7253 successful procedures. The c-statistic for allcause mortality was 0.69 for the MCRS model alone and 0.75 for the MCRS and CAD-specific indices together (likelihood ratio test, p,0.001), indicating significant improvement in the discriminatory ability. Conclusions: Addition of comorbid conditions to the MCRS adds significant prognostic information for postdismissal mortality but adds little prognostic information about in-hospital complications after PCI. Such health-status measures should be included in future risk stratification models that predict long-term mortality after PCI.

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“…2 studies 14,35 studied the relationship between incremental rise in CCI score and mortality in patients with stable coronary heart disease ( Figure 3B) suggesting that incremental increases in CCI score were associated with worse outcomes (RR 1.38 95%CI 1.29-1.48, I 2 =0%). Sachdev et al 35 also reported that patients with a CCI score of 0 have better long-term survival (RR 1.88 95%CI 1.48-2.38).…”

Section: Stable Coronary Heart Diseasementioning

confidence: 99%

Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident: a systematic review and meta-analysis

Rashid

Kwok

Gale

et al. 2016

Eur Heart J Qual Care Clin Outcomes

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Abstract:Aims: We sought to investigate the prognostic impact of co-morbid burden as defined by the Charlson comorbidity index (CCI) in patients with a range of prevalent cardiovascular diseases. Methods & Results:We searched MEDLINE and EMBASE to identify studies that evaluated the impact of CCI on mortality in patients with cardiovascular disease. A random effects meta-analysis was undertaken to evaluate the impact of CCI on mortality in patients with coronary heart disease (CHD), heart failure (HF) and cerebrovascular accident (CVA).A total of 11 studies of acute coronary syndrome (ACS), 2 stable coronary disease, 5 percutaneous coronary intervention (PCI), 13 HF and 4 CVA met the inclusion criteria. An increase in CCI score per point was significantly associated with a greater risk of mortality in patients with ACS (pooled relative risk ratio (RR) 1.33 95%CI 1.15-1.54), PCI (RR 1.21 95% CI1.12-1.31) stable coronary artery disease (RR 1.38 95%CI 1.29-1.48) and HF (RR1.21 95%CI 1.13-1.29), but not CVA. A CCI score >2 significantly increased the risk of mortality in ACS (RR 2.52 95% CI 1.58-4.04), PCI (3.36 95%CI 2.14-5.29), HF (RR 1.76 95%CI 1.65-1.87) and CVA . Conclusion:Increasing co-morbid burden as defined by CCI is associated with a significant increase in risk of mortality in patients with underlying CHD, HF and CVA. CCI provides a simple way of predicting adverse outcomes in patients with CV disease and should be incorporated into decision-making processes when counseling patients.

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Evaluation of comorbidity scores to predict all-cause mortality in patients with established coronary artery disease

Cited by 27 publications

References 22 publications

Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Comorbid conditions and outcomes after percutaneous coronary intervention

Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure, and cerebrovascular accident: a systematic review and meta-analysis

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