Author + information
- Received April 10, 1984
- Revision received November 6, 1984
- Accepted November 15, 1984
- Published online May 1, 1985.
- Robert M. Califf, MD*,1,
- Harry R. Phillips III, MD, FACC1,
- Michael C. Hindman, MD1,
- Daniel B. Mark, MD1,
- Kerry L. Lee, PhD1,
- Victor S. Behar, MD, FACC1,
- Robert A. Johnson, MD1,
- David B. Pryor, MD1,
- Robert A. Rosati, MD, FACC1,
- Galen S. Wagner, MD1 and
- Frank E. Harrell Jr., PhD1
- ↵*.Address for reprints: Robert M. Califf, MD, Box 31123, Duke University Medical Center, Durham, North Carolina 27710.
The prognostic value of a coronary artery jeopardy score was evaluated in 462 consecutive nonsurgically treated patients with significant coronary artery disease, but without significant left main coronary stenosis. The jeopardy score is a simple method for estimating the amount of myocardium at risk on the basis of the particular location of coronary artery stenoses. In patients with a previous myocardial infarction, higher jeopardy scores were associated with a lower left ventricular ejection fraction. When the jeopardy score and the number of diseased vessels were considered individually, each descriptor effectively stratified prognosis. Five year survival was 97% in patients with a jeopardy score of 2 and 95, 85, 78, 75 and 56%, respectively, for patients with a jeopardy score of 4, 6, 8, 10 and 12. In multivariable analysis when only jeopardy score and number of diseased vessels were considered, the jeopardy score contained all of the prognostic information. Thus, the number of diseased vessels added no prognostic information to the jeopardy score. The left ventricular ejection fraction was more closely related to prognosis than was the jeopardy score. When other anatomic factors were examined, the degree of stenosis of each vessel, particularly the left anterior descending coronary artery, was found to add prognostic information to the jeopardy score.
Thus, the jeopardy score is a simple method for describing the coronary anatomy. It provides more prognostic information than the number of diseased coronary arteries, but it can be improved by including the degree of stenosis of each vessel and giving additional weight to disease of the left anterior descending coronary artery. Other factors, especially left ventricular function and the functional status of the patient, must also be considered when prognostic estimates are made.
- Received April 10, 1984.
- Revision received November 6, 1984.
- Accepted November 15, 1984.
- American College of Cardiology Foundation