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Akyuz S, Calik AN, Onuk T, Yaylak B, Kolak Z, Eren S, Mollaalioglu F, Durak F, Cetin M, Tanboga IH. The predictive value of PRECISE-DAPT score for long-term mortality in patients with acute coronary syndrome complicated by cardiogenic shock. Herz 2024; 49:302-308. [PMID: 38172314 DOI: 10.1007/s00059-023-05231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/25/2023] [Accepted: 11/25/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Besides its primary clinical utility in predicting bleeding risk in patients with acute coronary syndrome (ACS), the PRECISE-DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Anti-Platelet Therapy) score may also be useful for predicting long-term mortality in ACS patients presenting with cardiogenic shock (CS) since several studies have reported an association between the score and certain cardiovascular conditions or events. The aim of the present study was to evaluate the utility of the PRECISE-DAPT score for predicting the long-term all-cause mortality in patients (n = 293) with ACS presenting with CS. METHODS The PRECISE-DAPT score was calculated for each patient who survived in hospital, and the association with long-term mortality was studied. Median follow-up time was 2.7 years. The performance of the final model was determined with measurements of its discriminative power (Harrell's and Uno's C indices and time-dependent area under the receiver operating characteristic curve [AUC]) and predictive accuracy (coefficient of determination [R2] and likelihood ratio χ2). Hazard ratios (HRs) were used to assess the relationship between the variables of the model and long-term all-cause death. RESULTS All-cause death occurred in 197 patients (67%). There was a positive association between the PRECISE-DAPT score (change from 17 to 38 was associated with an HR of 2.42 [95% CI: 1.59-3.68], R2 = 0.209, time-dependent AUC = 0.69) and the risk of death such that in the adjusted survival curve, the risk of mortality increased as the PRECISE-DAPT score increased. CONCLUSION The PRECISE-DAPT score may be a useful easy-to-use tool for predicting long-term mortality in patients with ACS complicated by CS.
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Affiliation(s)
- Sukru Akyuz
- Department of Cardiology, Faculty of Medicine, Okan University, Acibadem Mahallesi, Elysium Elit Kosuyolu A Blok D.1, Kadikoy, Istanbul, Turkey.
| | - Ali Nazmi Calik
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Tolga Onuk
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Baris Yaylak
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Kolak
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Semih Eren
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Feyza Mollaalioglu
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Furkan Durak
- Department of Cardiology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Cetin
- Department of Cardiology, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey
| | - Ibrahim Halil Tanboga
- Department of Biostatistics, Nisantasi University Medical School, Istanbul, Turkey
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
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Attachaipanich T, Putchagarn P, Thonghong T, Leemasawat K, Pota P, Phoksiri A, Kuanprasert S, Suwannasom P. Impact of the completeness of revascularization and high bleeding risk status in acute coronary syndrome patients with multi-vessel disease: A retrospective analysis. JRSM Cardiovasc Dis 2024; 13:20480040241283152. [PMID: 39346685 PMCID: PMC11437547 DOI: 10.1177/20480040241283152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 08/21/2024] [Accepted: 08/28/2024] [Indexed: 10/01/2024] Open
Abstract
Objectives To investigate the long-term mortality of acute coronary syndrome (ACS) patients with multivessel disease according to the level of completeness of revascularization (CR) and high-bleeding risk (HBR) status. Design Setting and Participants This retrospective study collected the data of ACS patients with multivessel disease who underwent percutaneous coronary intervention between May 2018 and February 2019. Complete to reasonable revascularization (CR) was defined by the residual Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score (RSS) of 0 to ≤8. The HBR was defined by the PRECISE-DAPT score ≥25. Main Outcome Measures The all-cause death at 36 months according to the CR and HBR status. Results A total of 209 patients with 743 lesions were included in the analysis. The median follow-up was 3.6 years. Patients with CR had lower event rates than ICR (4.5 vs. 11.5 per 100 patient-year, HR 0.39, 95% CI 0.22-0.70), p = 0.002). Similar observations were noted when compared between non-HBR and HBR (3.9 vs. 11.1 per 100 patient-year, HR 0.35, 95% CI 0.18-0.64, p < 0.001). Kaplan-Meier analysis revealed that all-cause death was highest among those in the ICR/HBR (40.5%) followed by ICR/non-HBR (28.6%), CR/non-HBR (28.3%) and the lowest among the CR/HBR group (7.1%), log-rank p = <0.001. No significant interaction was observed between the two factors regarding all-cause death (p = 0.10 for interaction). Conclusions In ACS patients with MVD, the achievement of CR was associated with reducing mortality rates and consistency irrespective of the HBR status. (Trial Registration: TCTR20211222003).
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Affiliation(s)
- Tanawat Attachaipanich
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Tasalak Thonghong
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krit Leemasawat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Panupong Pota
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Aekapat Phoksiri
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Srun Kuanprasert
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pannipa Suwannasom
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Polat F, Yaylak B, Onuk T, Çalık AN, Akyüz Ş, Dayı ŞÜ. Predictive value of PRECISE-DAPT score for long-term all-cause mortality in atrial fibrillation patients with non-ST-elevation myocardial infarction. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2023; 19:217-224. [PMID: 37854965 PMCID: PMC10580842 DOI: 10.5114/aic.2023.131474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/19/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Atrial fibrillation (AF) may co-exist in patients with non-ST-elevation myocardial infarction (NSTEMI). In patients with NSTEMI, AF should therefore be regarded as an important risk factor irrespective of its presentation. To predict outcomes in AF patients presenting with NSTEMI, early risk stratification can help to identify the patients with a possible poor long-term prognosis. The development of the PRECISE-DAPT score aimed to predict the risk of bleeding in patients who underwent stent implantation and received dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI), providing a valuable tool for assessing bleeding risk in this specific patient population. Aim To assess the performance of the PRECISE-DAPT score in predicting long-term prognosis in AF patients with NSTEMI. Material and methods Five hundred and twenty-six consecutive AF patients presenting with NSTEMI were included in the present study. The PRECISE-DAPT score was calculated in each case and evaluated for the association of increased mortality in the study population, who survived in-hospital but died in the long term. Results All-cause mortality deaths occurred in 278 (52.6%) patients. Higher PRECISE-DAPT score, shorter duration of P2Y12 inhibitor therapy, decreased left ventricular ejection fraction (LVEF), and a history of diabetes mellitus (DM) were all associated with an increased risk of all-cause mortality in the multivariable logistic regression model. Conclusions High PRECISE-DAPT score was associated with higher long-term all-cause mortality in AF patients presenting with NSTEMI.
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Affiliation(s)
- Fuat Polat
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Barış Yaylak
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tolga Onuk
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ali Nazmi Çalık
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Şükrü Akyüz
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Şennur Ünal Dayı
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Ramazanoglu L, Kalyoncu Aslan I, Bugrul A, Onal Y, Velioglu M, Topcuoglu OM, Gozke E. Prediction of Bleeding by the PRECISE-DAPT Score in Patients with Carotid Artery Stenting. Cardiovasc Intervent Radiol 2023; 46:574-578. [PMID: 37012393 DOI: 10.1007/s00270-023-03419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/11/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE The predicting bleeding complications in patients undergoing stent implantation and the subsequent dual antiplatelet therapy (PRECISE-DAPT) score predicts the risk of bleeding in patients with dual antiplatelet therapy (DAPT) after percutaneous coronary interventions (PCIs). Patients with carotid artery stenting (CAS) are also treated with DAPT. In this study, we aimed to investigate the performance of the PRECISE-DAPT score in predicting bleeding in patients with CAS. METHODS Patients who had CAS between January 2018 and December 2020 were retrospectively enrolled. The PRECISE-DAPT score was calculated for each patient. The patients were divided into two groups based on their PRECISE-DAPT score: low < 25 and high ≥ 25. Bleeding and ischemia complications and laboratory data among the two groups were compared. RESULTS A total of 120 patients with a mean age of 67.3 ± 9.7 years were included. Forty-three patients had high PRECISE-DAPT scores, and 77 patients had low PRECISE-DAPT scores. Six patients developed bleeding events during the six-month follow-up, and five of them were in the PRECISE DAPT score ≥ 25 group. The difference between the two groups regarding bleeding events at six months was significant (P = 0.022). CONCLUSION The PRECISE-DAPT score might be used for predicting the bleeding risk in patients with CAS, and the bleeding rate was significantly higher in patients with a PRECISE-DAPT score ≥ 25.
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Affiliation(s)
- Leyla Ramazanoglu
- Department of Neurology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
| | - Isil Kalyoncu Aslan
- Department of Neurology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Bugrul
- Meram Faculty of Medicine, Department of Neurology, Necmettin Erbakan University, Konya, Turkey
| | - Yilmaz Onal
- Department of Radiology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Murat Velioglu
- Department of Radiology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | | | - Eren Gozke
- Department of Neurology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Alıcı G, Genç Ö, Urgun ÖD, Erdoğdu T, Yıldırım A, Quisi A, Kurt İH. The value of PRECISE-DAPT score and lesion complexity for predicting all-cause mortality in patients with NSTEMI. Egypt Heart J 2023; 75:2. [PMID: 36602654 PMCID: PMC9816365 DOI: 10.1186/s43044-023-00329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We aimed to evaluate the prognostic effects of stroke risk scores (SRS), SYNTAX score (SX score), and PRECISE-DAPT score on mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Three hundred forty-three patients hospitalized with a diagnosis of NSTEMI and underwent coronary angiography (CAG) between January 1, 2022, and June 1, 2022, were included retrospectively in this single-center study. Patients' demographic, clinical and routine biochemical parameters were recorded. The scores (CHADS2, CHA2DS2-VASc, R2CHA2DS2-VASc, ATRIA, SX score, PRECISE-DAPT) of each patient were calculated. Participants were then divided into two groups by in-hospital status; all-cause mortality (+) and all-cause mortality (-). RESULTS Overall, the mean age was 63.5 ± 11.8 years, of whom 63.3% (n = 217) were male. In-hospital mortality occurred in 31 (9.3%) patients. In the study population, those who died had significantly higher SX (p < 0.001), PRECISE-DAPT (p < 0.001), and ATRIA (p = 0.002) scores than those who survived. In logistic regression analysis, PRECISE-DAPT score [Odds ratio (OR) = 1.063, 95% CI 1.014-1.115; p = 0.012] and SX score [OR: 1.061, 95% CI 1.015-1.109, p = 0.009] were found to be independent predictors of in-hospital all-cause mortality among NSTEMI patients. In ROC analysis, the PRECISE-DAPT score performed better discriminative ability than the SX score in determining in-hospital mortality [Area under the curve = 0.706, 95% CI 0.597-0.814; p < 0.001]. CONCLUSIONS During the hospital stay, both PRECISE-DAPT and SX scores showed better performance than SRS in predicting all-cause mortality among NSTEMI patients undergoing CAG. Aside from their primary purpose, both scores might be useful in determining risk stratification for such patient populations.
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Affiliation(s)
- Gökhan Alıcı
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey.
| | - Ömer Genç
- Department of Cardiology, Çam and Sakura City Hospital, Istanbul, Turkey
| | | | - Tayfur Erdoğdu
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
| | - Abdullah Yıldırım
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
| | - Alaa Quisi
- Department of Cardiology, Adana Medline Hospital, Adana, Turkey
| | - İbrahim Halil Kurt
- Department of Cardiology, Adana City Training and Research Hospital, Dr. Mithat Özsan Boulevard, 4522, Yuregir, Adana, Turkey
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Kubota N, Ozaki K, Akiyama T, Washiyama Y, Yoneyama S, Okubo T, Ikegami R, Hoyano M, Yanagawa T, Tanabe N, Inomata T. Correlation Between the Japanese Version of the High Bleeding Risk (J-HBR) Criteria and the PRECISE-DAPT Score, and Optimal J-HBR Cut-Off Score to Predict Major Bleeding. Circ Rep 2022; 4:363-370. [PMID: 36032388 PMCID: PMC9360984 DOI: 10.1253/circrep.cr-22-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The correlation between the Japanese version of high bleeding risk (J-HBR) criteria and the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score is unknown, as is the relationship of both risk scores with ischemic events. Methods and Results: This study enrolled 842 patients who underwent percutaneous coronary intervention (PCI) between January 2016 and December 2020. The 2 bleeding risk scores at the time of PCI and the subsequent risk of bleeding and ischemic events over a 1-year follow-up were examined. The J-HBR score was significantly correlated with the PRECISE-DAPT score (r=0.731, P<0.001). However, 1 year after PCI, the J-HBR was not significantly associated with the incidence of major bleeding and ischemic events (log-rank, P=0.058 and P=0.351, respectively), whereas the PRECISE-DAPT score predicted both the incidence of major bleeding and ischemic events (log-rank, P=0.006 and P=0.019, respectively). According to receiver operating characteristic curve analysis, a J-HBR score ≥1.5 was significantly associated with a higher cumulative incidence of major bleeding, but not ischemic events (log-rank, P=0.004 and P=0.513, respectively). Conclusions: The J-HBR score is highly correlated with the PRECISE-DAPT score. A J-HBR score ≥1.5 can identify high bleeding risk patients without an increased risk of ischemic events.
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Affiliation(s)
- Naoki Kubota
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kazuyuki Ozaki
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takumi Akiyama
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Yuzo Washiyama
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Shintaro Yoneyama
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takeshi Okubo
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Ryutaro Ikegami
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Makoto Hoyano
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Takao Yanagawa
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Naohito Tanabe
- Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences
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Rowland B, Batty JA, Dangas GD, Mehran R, Kunadian V. Oral Antiplatelet Agents in Percutaneous Coronary Intervention. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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García-Rodeja Arias F, Álvarez Álvarez B, González Ferrero T, Martinón Martínez J, Otero García Ó, Tasende Rey P, Cacho Antonio CE, Abou Jokh Casas C, Zuazola P, Jiménez Ramos V, Cordero A, Escribano D, Cid Álvarez B, Iglesias Álvarez D, Agra Bermejo RM, Rigueiro Veloso P, García Acuña JM, Gude Sampedro F, González Juanatey JR. Should PRECISE-DAPT be included for long-term prognostic stratification of diabetic patients with NSTEACS? Acta Diabetol 2022; 59:163-170. [PMID: 34515850 DOI: 10.1007/s00592-021-01792-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
AIMS There are insufficient data regarding risk scores validation in patients with diabetes mellitus and non-ST elevation acute coronary syndrome (NSTEACS). We performed a diabetes mellitus-specific analysis of cardiovascular outcomes after NSTEACS. We tested the predictive power of the Global Registry of Acute Coronary Events (GRACE) and PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy (PRECISE-DAPT) scores. METHODS This work is a retrospective analysis that included 7,415 consecutive NSTEACS patients from two Spanish Universitarian hospitals between the years 2003 and 2017. The area under the ROC curve among with and without diabetes mellitus patients was calculated, to evaluate the predictive power of both scores. RESULTS: Among the study participants, 2124 patients (28.0%) were diabetic. The median follow-up was 54,3 months (IQR 24,7-80,0 months). Diabetic patients were more women (30.5% vs. 25.7%) and older (70.0 ± 10.8 vs. 65.3 ± 13.2 years old); they had higher GRACE (146 ± 36 vs. 137 ± 36), PRECISE-DAPT (15 ± 7 vs. 18 ± 9) at admission. Early invasive coronary angiography (≤ 24 h after admission) was performed more frequently in non-diabetic. We tested the predictive power of the GRACE and PRECISE-DAPT risk scores among diabetic and non-diabetic. PRECISE-DAPT risk score showed a good predictive power for all-cause mortality, cardiovascular mortality and MACE in diabetic admitted with NSTEACS, without differences compared to non-diabetic. CONCLUSIONS PRECISE-DAPT risk score has an appropriate predictive power in diabetic patients admitted with NSTEACS compared to non-diabetic NSTEACS. However, GRACE would be predictive worse in diabetic during long-term follow-up in a large contemporary registry.
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Affiliation(s)
- Federico García-Rodeja Arias
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain.
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain.
| | - Belén Álvarez Álvarez
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Teba González Ferrero
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Jesús Martinón Martínez
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Óscar Otero García
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Pablo Tasende Rey
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Carla Eugenia Cacho Antonio
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Charigan Abou Jokh Casas
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Pilar Zuazola
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital of San Juan, Alicante, Spain
| | - Víctor Jiménez Ramos
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Alberto Cordero
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital of San Juan, Alicante, Spain
| | - David Escribano
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
- Cardiology Department, University Hospital of San Juan, Alicante, Spain
| | - Belén Cid Álvarez
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Diego Iglesias Álvarez
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Rosa María Agra Bermejo
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Pedro Rigueiro Veloso
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - José María García Acuña
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Francisco Gude Sampedro
- Epidemiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Ramón González Juanatey
- Cardiology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana s/n. 15703, Santiago de Compostela, Spain
- Biomedical Research Networking Center On Cardiovascular Diseases (CIBERCV), Madrid, Spain
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Akama J, Shimizu T, Ando T, Anzai F, Muto Y, Kimishima Y, Kiko T, Yoshihisa A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y. Prognostic Value of the Pattern of Non-Adherence to Anti-Platelet Regimen in Stented Patients (PARIS) Bleeding Risk Score for Long-Term Mortality After Percutaneous Coronary Intervention. Int Heart J 2022; 63:15-22. [DOI: 10.1536/ihj.21-440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Joh Akama
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Takeshi Shimizu
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Takuya Ando
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Fumiya Anzai
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yuuki Muto
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Takatoyo Kiko
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Takayoshi Yamaki
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Hiroyuki Kunii
- Department of Cardiovascular Medicine, Fukushima Medical University
| | | | - Takafumi Ishida
- Department of Cardiovascular Medicine, Fukushima Medical University
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10
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Sato Y, Yoshihisa A, Takeishi R, Ohara H, Sugawara Y, Ichijo Y, Hotsuki Y, Watanabe K, Abe S, Misaka T, Sato T, Oikawa M, Kobayashi A, Nakazato K, Takeishi Y. Simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) Definition Predicts Bleeding Events in Patients With Heart Failure. Circ J 2021; 86:147-155. [PMID: 34707066 DOI: 10.1253/circj.cj-21-0686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It has recently been reported that the simplified Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition, which excludes 6 rare criteria, is comparable to the original ARC-HBR definition in predicting major bleeding in patients with coronary artery disease (CAD) who undergo percutaneous coronary intervention. In this study, we investigated whether the simplified ARC-HBR definition could be applied to patients with heart failure (HF) to identify those at high bleeding risk (HBR). METHODS AND RESULTS In all, 2,437 patients hospitalized for HF were enrolled in this study. Patients were divided into 2 groups based on the simplified ARC-HBR definition: those at HBR (n=2,026; 83.1%) and those not (non-HBR group; n=411; 16.9%). The HBR group was older (72.0 vs. 61.0 years; P<0.001) and had a lower prevalence of CAD (31.1% vs. 36.5%; P=0.034) than the non-HBR group. Kaplan-Meier analysis showed that post-discharge bleeding events defined as hemorrhagic stroke or gastrointestinal bleeding were more frequent in the HBR than non-HBR group (log-rank P<0.001). The simplified ARC-HBR definition accurately predicted bleeding events (Fine-Gray model; hazard ratio 2.777, 95% confidence interval 1.464-5.270, P=0.001). CONCLUSIONS The simplified ARC-HBR definition predicts a high risk of bleeding events in patients with HF.
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Affiliation(s)
- Yu Sato
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University
- Department of Clinical Laboratory Sciences, Fukushima Medical University School of Health Science
| | - Ryohei Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Himika Ohara
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yukiko Sugawara
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yasuhiro Ichijo
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Yu Hotsuki
- Department of Cardiovascular Medicine, Fukushima Medical University
| | | | - Satoshi Abe
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Takamasa Sato
- Department of Cardiovascular Medicine, Fukushima Medical University
| | - Masayoshi Oikawa
- Department of Cardiovascular Medicine, Fukushima Medical University
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11
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Predictors of renal infarction in patients presenting to the emergency department with flank pain: A retrospective observational study. PLoS One 2021; 16:e0261054. [PMID: 34874969 PMCID: PMC8651137 DOI: 10.1371/journal.pone.0261054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Flank pain is a common symptom in the emergency department and can be caused by a variety of diseases. Renal infarction (RI) is a very rare disease, and many RI patients complain of flank pain. However, there is no definitive predictor of RI when patients complain of flank pain. This study aimed to identify the clinical factors for predicting RI in patients with flank pain. Methods This retrospective single-center study was conducted on patients complaining of flank pain from January 2016 to March 2020 at a South Korean tertiary care hospital. Exclusion criteria included patients who did not undergo contrast-enhanced computed tomography, age < 18 years, and trauma. Demographic and laboratory data were obtained from medical records. Logistic regression analysis was conducted to identify predictors of RI occurrence. Results In all, 2,131 patients were enrolled, and 39 (1.8%) had RI. From a multivariable logistic regression analysis, an age ≥ 65 years (odds ratio [OR], 3.249; 95% confidence interval [CI], 1.366–7.725; p = 0.008), male sex (OR, 2.846; 95% CI, 1.190–6.808; p = 0.019), atrial fibrillation (OR, 10.386; 95% CI, 3.724–28.961; p < 0.001), current smoker (OR, 10.022; 95% CI, 4.565–22.001; p < 0.001), and no hematuria (OR, 0.267; 95% CI, 0.114–0.628; p = 0.002) were significantly associated with the occurrence of RI. Conclusions Five clinical factors, i.e., age ≥ 65 years, male sex, atrial fibrillation, current smoker, and no hematuria, were significantly associated with the occurrence of RI in patients with flank pain.
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12
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Şaylık F, Akbulut T. The association of PRECISE-DAPT score with thrombus burden in patients with ST-segment elevation myocardial infarction. Acta Cardiol 2021; 77:449-455. [PMID: 34309488 DOI: 10.1080/00015385.2021.1954747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The presence of intracoronary thrombus is associated with adverse events in patients with ST-segment elevation myocardial infarction (STEMI). PRECISE-DAPT score is used to detect the bleeding risk in STEMI patients who are on dual antiplatelet therapy. Recently, the PRECISE-DAPT score was shown to be related to cardiovascular events. We aimed to investigate the association of PRECISE-DAPT score with thrombus burden in patients with STEMI. METHODS A retrospective analysis with 204 STEMI patients undergoing primary percutaneous coronary intervention was conducted in this study. Thrombus burden grade and PRECISE-DAPT score were calculated for each subject. Patients were divided into two groups as high thrombus burden (HTB) (grade 4, 5) and low thrombus burden (LTB) (grade 1, 2 and 3) based on thrombus burden grade. The PRECISE-DAPT scores were compared between thrombus burden groups. RESULTS The mean age in HTB (N = 136) was 63.7 (11.3), and 64.7% were male. HTB had a higher PRECISE-DAPT score than LTB (p < .0001). PRECISE-DAPT score, baseline troponin I levels, ejection fraction, and pain to balloon time were independent predictors of HTB. CONCLUSIONS PRECISE-DAPT score was an independent predictor of HTB in patients with STEMI.
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Affiliation(s)
- Faysal Şaylık
- Department of Cardiology, Van Training and Research Hospital, Health Science University, Van, Turkey
| | - Tayyar Akbulut
- Department of Cardiology, Van Training and Research Hospital, Health Science University, Van, Turkey
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13
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Selçuk M, Çınar T, Şaylık F, Demiroz Ö, Yıldırım E. The Association of a PRECISE-DAPT Score With No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2021; 73:68-72. [PMID: 33878953 DOI: 10.1177/00033197211010602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the association of admission PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score with the development of no-reflow (NR) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). In this observational, retrospective study, 335 consecutive STEMI patients who were treated with primary PCI were included. We classified the study population into 2 groups: patients with a PRECISE-DAPT score <25 and those with a PRECISE-DAPT score ≥25. Overall, 30 (8.9%) patients developed NR. The mean PRECISE-DAPT score (20.03 ± 15.32 vs 11.33 ± 12.18; P = .005) was significantly higher in cases who developed NR. Moreover, arrhythmic complications, in-hospital shock, and in-hospital mortality rates were significantly higher in patients with a PRECISE-DAPT score ≥25 compared to those with a PRECISE-DAPT score <25. According to a multivariable analysis, the PRECISE-DAPT score was found to be independently linked with NR (odds ratio: 2.87, with P = .015). To our knowledge, these data are the first in major medical science databases to determine the relationship between the PRECISE-DAPT score and the NR phenomenon in patients with STEMI undergoing primary PCI.
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Affiliation(s)
- Murat Selçuk
- Department of Cardiology, Sultan II. Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Tufan Çınar
- Department of Cardiology, Sultan II. Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Faysal Şaylık
- Department of Cardiology, Van Training and Research Hospital, Van, Turkey
| | - Önder Demiroz
- Department of Cardiology, Ümraniye Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Ersin Yıldırım
- Department of Cardiology, Ümraniye Training and Research Hospital, Health Sciences University, Istanbul, Turkey
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Dannenberg L, Afzal S, Czychy N, M'Pembele R, Zako S, Helten C, Mourikis P, Zikeli D, Ahlbrecht S, Trojovsky K, Benkhoff M, Barcik M, Wolff G, Zeus T, Kelm M, Polzin A. Risk prediction of bleeding and MACCE by PRECISE-DAPT score post-PCI. IJC HEART & VASCULATURE 2021; 33:100750. [PMID: 33763519 PMCID: PMC7973296 DOI: 10.1016/j.ijcha.2021.100750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/06/2021] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Guidelines recommend the PRECISE-DAPT (PD) score to adapt duration of dual antiplatelet therapy due to bleeding risk. However, there is first evidence that PD predicts mortality and ischemic events as well. METHODS We investigated PD Score in 994 patients after percutaneous coronary intervention (PCI). PD was correlated with clinically frequently used scores. Major adverse cardiac and cerebrovascular events (MACCE) and Thrombolysis in Myocardial Infarction (TIMI) bleeding were assessed during one-year follow-up. RESULTS 524 patients had PD < 25 and 470 patients PD ≥ 25 (47%). Rate of major and minor bleeding was higher in the PD ≥ 25 group (major bleeding: Hazard ratio [HR] 2.9, 95% confidence interval [Cl] 1.01-8.16, p = 0.049; minor bleeding: HR 3.94, 95% Cl 1.36-9.19, p = 0.0096). Rate of MACCE, death and myocardial infarction were higher as well (MACCE: HR 2.0, 95% Cl 1.52-2.71, p < 0.0001; death: HR 3.9, 95% Cl 2.12-5.68, p < 0.0001; MI: HR 2.1, 95% Cl 1.26-3.43, p = 0.0041). Rate of stroke/transient ischemic attack did not differ between groups. Discriminative potency to predict major and minor bleeding, MACCE, death and MI were high with nearly equal cut-off values calculated by Youden's index (YI) (major bleeding: Area under the curve [AUC] 0.66; p = 0.026; YI 32; minor bleeding: AUC 0.72; p = 0.001; YI 28; MACCE: AUC 0.62; p < 0.0001; YI 24). CONCLUSION In our cohort, PD score predicted bleeding moderately in post-PCI patients. In this study, ischemic events were predicted as well. Adaption of antiplatelet therapy duration by PD score is accurate. Nevertheless, it should be well-balanced with patient-related risk for ischemic events.
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Key Words
- AF, Atrial fibrillation
- Bleeding
- DAPT
- DAPT, Dual antiplatelet medication
- GRACE, Global Registry of Acute Coronary Events
- MACCE
- MACCE, Major adverse cardiac and cerebrovascular events
- PARIS, Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients
- PCI, percutaneous coronary intervention
- PD, PRECISE-DAPT, PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Antiplatelet Therapy
- ROC, Receiver operating characteristic
- STEMI, ST-elevation myocardial infarction
- Scores
- TIA, Transient ischemic attack
- TIMI
- TIMI, Thrombolysis in myocardial infarction
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Affiliation(s)
- Lisa Dannenberg
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Shazia Afzal
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Natalia Czychy
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - René M'Pembele
- Department of Anesthesiology, University Hospital Duesseldorf, Germany
| | - Saif Zako
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Carolin Helten
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Philipp Mourikis
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Dorothee Zikeli
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Samantha Ahlbrecht
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Kajetan Trojovsky
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Marcel Benkhoff
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Maike Barcik
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Georg Wolff
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Tobias Zeus
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Malte Kelm
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Amin Polzin
- Cardiovascular Research Institute Düsseldorf (CARID), Division of Cardiology, Pulmonology, and Vascular Medicine, University Duesseldorf, Medical Faculty, Duesseldorf, Germany
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Differential prognostic accuracy of right ventricular dysfunction, the Seattle heart failure model and the MAGGIC score in patients with severe mitral regurgitation undergoing the MitraClip® procedure. IJC HEART & VASCULATURE 2020; 31:100641. [PMID: 33088899 PMCID: PMC7566949 DOI: 10.1016/j.ijcha.2020.100641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022]
Abstract
Background MitraClip ® (MC) is an established procedure for severe mitral regurgitation (MR) in patients deemed unsuitable for surgery. Right ventricular dysfunction (RVD) is associated with a higher mortality risk. The prognostic accuracy of heart failure risk scores like the Seattle heart failure model (SHFM) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in pts undergoing MC with or without RVD has not been investigated so far. Methods SHFM and MAGGIC score were calculated retrospectively. RVD was determined as tricuspid annular plane systolic excursion (TAPSE) ≤15 mm. Area under receiver operating curves (AUROC) of SHFM and MAGGIC were performed for one-year all-cause mortality after MC. Results N = 103 pts with MR III° (73 ± 11 years, LVEF 37 ± 17%) underwent MC with a reduction of at least I° MR. One-year mortality was 28.2%. In Kaplan-Meier analysis, one- year mortality was significantly higher in RVD-pts (34.8% vs 2.8%, p = 0.009). Area under the Receiver Operating Characteristic (AUROC) for SHFM and MAGGIC were comparable for both scores (SHFM: 0.704, MAGGIC: 0.692). In pts without RVD, SHFM displayed a higher AUROC and therefore better diagnostic accuracy (SHFM: 0.776; MAGGIC: 0.551, p < 0.05). In pts with RVD, MAGGIC and SHFM displayed comparable AUROCs. Conclusion RVD is an important prognostic marker in pts undergoing MC. SHFM and MAGGIC displayed adequate over-all prognostic power in these pts. Accuracy differed in pts with and without RVD, indicating higher predictive power of the SHFM score in pts without RVD.
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