Multivariate prediction of major adverse cardiac events after 9914 percutaneous coronary interventions in the north west of England

Grayson, Antony D.; Moore, Roger K.; Jackson, Mark; Rathore, Sudhir; Sastry, Sanjay; Gray, Timothy P; Schofield, Ian; Chauhan, Anoop; Ordoubadi, F; Prendergast, Bernard; Stables, Rod

doi:10.1136/hrt.2005.066415

Cited by 59 publications

(68 citation statements)

References 21 publications

(15 reference statements)

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“…Approximately one-third of all patients undergoing percutaneous coronary intervention (PCI) have impaired left ventricular (LV) systolic function [left ventricular ejection fraction (LVEF) <50%] [1][2][3]. Registry data over the past two decades have identified impaired LVEF as an independent predictor of in-hospital mortality [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Registry data over the past two decades have identified impaired LVEF as an independent predictor of in-hospital mortality [1][2][3][4][5][6][7][8]. However, important advances have been made within interventional practice since these registry data were compiled, including lower profile balloons and stents, advent of drug-eluting stents, improvements in guidewire support, adjuvant pharmacotherapy and the increasing use of haemodynamic support devices, all of which have improved early and long-term outcomes after PCI.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does left ventricular function continue to influence mortality following contemporary percutaneous coronary intervention?

Silva

Webb

Sicard

et al. 2012

Coronary Artery Disease

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does left ventricular function continue to influence mortality following contemporary percutaneous coronary intervention?

Silva

Webb

Sicard

et al. 2012

Coronary Artery Disease

View full text Add to dashboard Cite

show abstract

“…3,4 Several studies have identified risk factors for major adverse outcomes after percutaneous or surgical coronary revascularization. [5][6][7][8] However, factor analyses for unprotected LMCA revascularization remain limited. Moreover, the currently used risk-scoring systems (ie, Euro-SCORE and Parsonnet score) were originally designed for preoperative risk stratification of CABG patients.…”

mentioning

confidence: 99%

Major Predictors of Long-Term Clinical Outcomes After Coronary Revascularization in Patients With Unprotected Left Main Coronary Disease

Min

Park

Yun

et al. 2010

Circ: Cardiovascular Interventions

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Background-The clinical characteristics that identify high-risk subsets of patients with unprotected left main coronary artery disease undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) have not been well established. Methods and Results-Between January 2000 and June 2006, 2240 patients with unprotected left main coronary artery disease underwent PCI (nϭ1102) or CABG (nϭ1138). Twenty-six preprocedural parameters were evaluated by univariate and multivariate Cox regression analysis to identify independent predictors of all-cause mortality and target-vessel revascularization. Interaction tests were performed to compare heterogeneities of effects of preprocedural parameters depending on the revascularization methods. During follow-up (median of 3.1 years), 187 patients died (78 PCI and 109 CABG) and 149 patients had target-vessel revascularization (121 PCI and 28 CABG). EuroSCORE Ն6 was an independent predictor of death in both groups. Additional independent predictors were chronic renal failure and previous congestive heart failure in the PCI group and age Ն75 years, atrial fibrillation, right coronary artery disease, and left main distal bifurcation disease in the CABG group. Interaction analysis showed no heterogeneities of the effects of variables depending on the revascularization methods. Independent predictors of target-vessel revascularization were acute coronary syndrome and left main distal bifurcation disease in the PCI group and history of coronary intervention in the CABG group. The interaction between previous PCI and treatment remained after adjustment for all independent predictors of target-vessel revascularization (interaction Pϭ0.0345). Conclusions-Several

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“…Several models or scoring systems to predict the likelihood of in-hospital death and other major adverse cardiac events (MACE) after PCI have been developed [9][10][11][12][13][14][15][16][17][18]. These were developed and validated using all patients undergoing PCI, not just elective patients; thus, several of the risk factors identified in these reports would not be applicable to the elective PCI patient (Table I).…”

Section: Pci Procedures Indications and Risk Stratificationmentioning

confidence: 99%

“…In-hospital mortality [9] In-hospital mortality, MACE [10] In-hospital mortality [11] In-hospital mortality, MACE [12] In-hospital mortality [13] In-hospital mortality [14] In-hospital mortality, MACE [15] In-hospital mortality [16] In-hospital mortality, MACE [17] In-hospital mortality [18] Variables applicable to elective PCI Age (years) might be to identify a patient with an increased risk. Such a patient would be excluded from same-day discharge and even considered for an extended period of care following PCI.…”

Section: Outcome(s) Predictedmentioning

confidence: 99%

Defining the length of stay following percutaneous coronary intervention

Chambers

Dehmer

Cox

et al. 2009

Cathet Cardio Intervent

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Percutaneous coronary intervention (PCI) is the most common method of coronary revascularization. Over time, as operator skills and technical advances have improved procedural outcomes, the length of stay (LOS) has decreased. However, standardization in the definition of LOS following PCI has been challenging due to significant physician, procedural, and patient variables. Given the increased focus on both patient safety as well as the cost of medical care, system process issues are a concern and provide a driving force for standardization while simultaneously maintaining the quality of patient care. This document:(1) provides a summary of the existing published data on same-day patient discharge following PCI, (2) reviews studies that developed methods to predict risk following PCI, and (3) provides clarification of the terms used to define care settings following PCI. In addition, a decision matrix is proposed for the care of patients following PCI. It is intended to provide both the interventional cardiologist as well as the facilities, in which they are associated, a guide to allow for the appropriate LOS for the appropriate patient who could be considered for early discharge or outpatient intervention. V C 2009 Wiley-Liss, Inc.

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Multivariate prediction of major adverse cardiac events after 9914 percutaneous coronary interventions in the north west of England

Abstract: A contemporaneous multivariate prediction model for MACE after PCI was developed. The NWQIP tool allows calculation of the risk of MACE permitting meaningful risk adjusted comparisons of performance between hospitals and operators.

Cited by 59 publications

References 21 publications

Does left ventricular function continue to influence mortality following contemporary percutaneous coronary intervention?

Does left ventricular function continue to influence mortality following contemporary percutaneous coronary intervention?

Major Predictors of Long-Term Clinical Outcomes After Coronary Revascularization in Patients With Unprotected Left Main Coronary Disease

Defining the length of stay following percutaneous coronary intervention

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