Author + information
- Benjamin Davies Hornea,b,
- J. Muhlesteina,b,
- Durgesh Bhandarya,b,
- Greta Hoetzera,b,
- Tami Baira,b,
- Naeem Khana,b and
- Donald Lappea,b
Background: Previously, 1- to 3- year post-myocardial infarction (MI) risk of major adverse cardiovascular events (MACE) was predicted by the Intermountain MACE (IMACE) risk scores, inexpensive electronically-delivered clinical decision tools created to tailor all post-MI patient care management. It is uncertain whether IMACE scores predict MACE in non-MI patients receiving stent placement.
Methods: Subjects aged ≥18 years and free of MI at baseline who had PCI with stent at the Intermountain Heart Institute (January 1997-April 2014) were evaluated (females, n=1,779; males, n=4,977). Subjects were followed to April 2015 for MACE (cardiovascular mortality, MI, or stroke). Stent recipients surviving ≥1 year event-free were included (12 months of DAPT was not required). IMACE was calculated from age and clinical labs (complete blood count, comprehensive metabolic profile, lipid panel, hemoglobin A1c, troponin I, B-type natriuretic peptide).
Results: Overall, 55% of subjects had unstable angina; females averaged 67.4±11.6 years of age and males averaged 63.0±11.2 years. IMACE stratified MACE (Figure) in both females (hazard ratio [HR]=1.31 per +1 score, 95% confidence interval [CI]=1.19, 1.44; p<0.001) and males (HR=1.24 per +1 score, CI=1.18, 1.30; p<0.001).
Conclusions: IMACE effectively predicted risk differences for non-MI stent recipients. IMACE is a feasible tool for efficiently identifying patients requiring enhanced evaluation and better tailoring of therapeutic management.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-347
- 2017 American College of Cardiology Foundation