Using the RISK-PCI Score in the Long-Term Prediction of Major Adverse Cardiovascular Events and Mortality after Primary Percutaneous Coronary Intervention

Abstract

Background/Aim The RISK-PCI is a simple score for the prediction of 30-day major adverse cardiovascular events (MACE) and mortality in patients treated with primary PCI (pPCI). The aim of the present study is to evaluate the prognostic performance of the RISK-PCI score in predicting MACE and mortality in the long-term follow-up of STEMI patients treated with pPCI. Method The present study enrolled 2,096 STEMI patients treated with pPCI included in the RISK-PCI trial. Patients presenting with cardiogenic shock were excluded. The composite end-point MACE comprising cardiovascular mortality, nonfatal reinfarction and stroke. Patients were followed up at 6 years after enrollment. Results One-year and 6-year MACE occurred in 229 (10.9%) and 285 (13.6%) patients, respectively; and 1-year and 6-year mortality occurred in 128 (6.2%) and 151 (7.2%) patients, respectively. The RISK-PCI score was an independent predictor for 1-year MACE (HR 1.24, 95% CI 1, 18–1.31, p < 0.001), 6-year MACE (HR 1.22, 95% CI 1.16–1.28, p < 0.001), 1-year mortality (HR 1.21, 95% CI 1.13–1.29, p < 0.001), and 6-year mortality (HR 1.23, 95% CI 1.15–1.31, p < 0.001). The discrimination of the RISK-PCI score to predict 1-year and 6-year MACE and mortality was good: for 1-year MACE c-statistic 0.78, for 6-year MACE c-statistic 0.75, for 1-year mortality c-statistic 0.87, and for 6-year mortality c-statistic 0.83. The nonsignificant Hosmer–Lemeshow goodness-of-fit estimates for 1-year MACE (p=0.619), 6-year MACE (p=0.319), 1-year mortality (p=0.258), and 6-year mortality (p=0.540) indicated a good calibration of the model. Conclusion The RISK-PCI score demonstrates good characteristics in the assessment of the risk for the occurrence of MACE and mortality during long-term follow-up after pPCI.

Correlation between RISK-PCI Score and Shock Index with in-Hospital and Long-Term Major Adverse Cardiovascular Events and Mortality after Primary Percutaneous Coronary Intervention in Patients of Acute Myocardial Infarction

“…Two patients had a myocardial infarction (MI), nine patients had heart failure, one patient had a stroke, and two patients died of cardiovascular causes during longterm follow-up. The discrimination of the RISK-PCI score to predict 1year MACE and death was pretty strong, as was shown in a previous research by [24], which corroborated our findings. The 1-year MACE c-statistics was 0.78 (95% CI 0.73-0.79, p 0.001), the 6-year MACE c-statistics was 0.75 (95% CI 0.68-0.75, p 0.001), the 1-year mortality cstatistics was 0.87 (95% CI 0.84-0.89, p 0.001), and the 6year mortality c-statistics was 0.83 (95% CI 0.…”

“…There was no statistically significant difference between the two groups in terms of RISK-PCI score, despite the fact that the mean score was greater for patients who had MACE and mortality during in-hospital follow-up compared to those in the Long term group. In a recent study [24] showed that, the RISK-PCI score remained an independent predictor for 1-year MACE (HR 1.24, 95% CI 1.18-1.31, p < 0.001), 6-year MACE (HR 1.22, 95% CI 1.16-1.28, p < 0.001), 1-year mortality (HR 1.21, 95% CI 1.13-1.29, p < 0.001), and 6-year mortality (HR 1.23, 95% CI 1.15-1.31, p < 0.001). Risk-PCI was significantly correlated with major adverse cardiac events (MACE), including death both during and after hospitalisation.…”

“…Sensitivity and specificity of risk PCI score in identifying MACE incidence, long term mortality, and in hospital mortality were 95.8% and 85.7%, respectively; sensitivity and specificity of Shock Index was 85.7 and 20.7 was achieved for long term mortality and in hospital mortality. Along with our results was a previous study aimed to evaluate the prognostic performance of the RISK-PCI score in predicting MACE and mortality in the long-term follow-up of STEMI patients treated with pPCI., [24]showed that, the RISK-PCI score demonstrates good characteristics in the assessment of the risk for the occurrence of MACE and mortality during long-term follow-up after pPCI. discrimination of the RISK-PCI score to predict 1-year and 6-year MACE and mortality was good: for 1-year MACE c-statistic 0.78, for 6-year MACE c-statistic 0.75, for 1-year mortality c-statistic 0.87, and for 6-year mortality c-statistic 0.83.…”

“…The sum of weighted points for 12 independent predictors was calculated to define the total score for each patient with a range of 0-20. Risk strata with low (0-2.5 points), intermediate (3-4.5 points), high (5-6.5 points), and very high (≥7 points) [24] Shock Index (SI) The shock index (SI) was a bedside assessment defined as heart rate divided by systolic blood pressure, with a normal range of 0.5 to 0.7. In this study, the value of SI was measured in the emergency department [25] Administrative design:  The purpose of the research was explained to all patients.…”

Rosuvastatin plus ticagrelor decreases the risk of major adverse cardiovascular events and elevates cardiac function compared with ticagrelor alone in patients undergoing percutaneous coronary intervention: A meta‑analysis

“…Previous studies have reported that the incidence of MACE is 10.9-30.5% if there is no related treatment among patients receiving PCI (23)(24)(25). Several therapies are recommended to prevent the incidence of MACE during the perioperative period of PCI according to the American College of Cardiology/AHA guidelines, among which statins serve a crucial role (26,27).…”