Author + information
- Analkumar Parikh,
- George Mwandia,
- Esteban Pena,
- Ajay Agarwal,
- Brian Schwartz,
- Harvey Hahn and
- Sula Mazimba
Octogenarians comprise an increasing proportion of patients undergoing percutaneous coronary interventions (PCI). There is paucity of outcomes data among octogenarians undergoing PCI as most are excluded from clinical trials. Four PCI risk scores, British Colombia (BC), Mayo Clinic, New York (NY) PCI, Euroheart risk (EU) scores have been validated to predict outcomes among patients undergoing PCI. We sought to compare expected and observed clinical events among these 4 risk scores in predicting outcomes.
1180 consecutive Octogenarians undergoing PCI were included in the study. Clinical, angiographic, and outcome variables were prospectively obtained. Clinical variables were applied to each of the risk scores to determine the predicted risk. Expected in-hospital, 30-day and 12-month outcomes were then compared to the observed corresponding interval mortality outcomes.
The mean age was 84 +/- 4 years. Fifty-three percent (625) were female. Eighty-seven percent (1028) had hypertension while 77% (914) had hyperlipidemia. Forty-nine percent (529) of the patients had presented with acute coronary syndrome. Seventy-one percent (838) had multivessel disease. Multivariate predictors of in-hospital mortality with statistical significance (p0.05) were: cardiogenic shock/iabp; in-hospital reinfarction; dialysis. The observed in-hospital, 30-day and 1-year mortality were 2% (24), 3% (39), and 5% (59) respectively. The mayo clinic risk score had in-hospital, 30-day, and 1-year mortality C statistic of 0.76 (p0.05), 0.81(p0.001), and 0.62(p0.28) respectively. The BC risk score had in-hospital, 30-day, and 1-year mortality C statistic of 0.66 (p0.73), 0.65 (p0.28), and 0.71 (p0.12). The EU risk score had in-hospital, 30-day, and 1-year mortality C statistic of 0.71 (p0.15), 0.74 (p0.11), and 0.66 (p0.44). The NY PCI risk score had in-hospital, 30-day, and 1-year mortality c statistic of 0.68 (p0.18), 0.67 (p0.36), and 0.61 (p0.20).
Among Octogenarians undergoing PCI, the Mayo PCI risk score had significantly better predictive ability of mortality for short term follow up than the British Columbia, Euroheart and New York heart PCI risk scores.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: AMI and PCI II
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1199-92
- 2013 American College of Cardiology Foundation