A simple risk score for prediction of mortality in patients undergoing percutaneous coronary intervention (PCI) for non-ST segment elevation acute coronary syndromes (NSTEACS)

Abstract

Aims: To develop an easily applicable prognostic model that can predict mortality risk in patients undergoing percutaneous coronary intervention (PCI) for non-ST segment elevation acute coronary syndromes (NSTEACS).

Methods and results: A retrospective analysis of 630 consecutive patients undergoing PCI for NSTEACS at our institution between January 1999 and December 2000 (development phase). Multivariate logistic regression analysis to identify independent predictors of mortality. Development of a 'weighted' and an 'unweighted' risk prediction model, each including the following 8 parameters: age > 65 years, age >75 years, left ventricular systolic function (LVEF) <50%, renal impairment (serum creatinine > 200 mmol/L), multi-vessel (3 vessel) disease, peripheral vascular disease, diabetes mellitus and female gender. Validation of the predictive model on the following 500 patients that underwent PCI over a 20 month period (validation phase). Prognostic models tested for their ability to predict mortality. The derived model was applied to the validation group and the area under receiver operating characteristic curves (ROC) was used to estimate the predictive ability of the prognostic models. The area under the ROC curve on the validation phase was 0.835, signifying a good ability to predict 30 day mortality following PCI.

Conclusion: We have derived a simple easily applicable predictive model based on readily available information that can predict mortality following PCI for NSTEACS.