1. Validation of a risk score for target vessel revascularization after coronary stent implantation
- Author
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Alexandre S, Quadros, Fabiane, Diemer, Dulce, Welter, Thais, Modkovski, Rogério, Sarmento-Leite, and Carlos A M, Gottschall
- Subjects
Male ,Coronary Stenosis ,Middle Aged ,Coronary Angiography ,Coronary Vessels ,Risk Assessment ,Cohort Studies ,Coronary Restenosis ,Diabetes Complications ,Research Design ,Humans ,Female ,Stents ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Aged ,Follow-Up Studies - Abstract
Our aim was to validate a risk score for new target vessel revascularization (TVR) after bare-metal stent (BMS) implantation.The risk score was developed in a cohort of patients previously treated with BMS at our institution. This risk score ranges from 0 to 5 points, according to the presence of diabetes mellitus (1 point), reference vessel diameter (3.5 mm = 0 points; 3-3.5 mm = 1;3 mm = 2) and lesion length (or = 10 mm = 0 points; 10-20 mm = 1;20 mm = 2). Patients included in the validation cohort were treated between January and December 2005. Patient characteristics and 1-year clinical follow up were prospectively recorded into a dedicated database. A new coronary angiography was performed only when recurrent ischemia was suspected.The mean age of the 491 patients included was 61 +/- 10.5 years, and 35% were women. Diabetes mellitus was present in 22%, a previous percutaneous coronary intervention in 12% and previous myocardial infarction in 35%. The mean reference vessel diameter was 2.80 +/- 0.56 mm and the mean lesion length was 12.45 +/- 6.3 mm. The overall 1-year TVR rate was 13.9%. TVR rates increased with each score level: Score = 0, TVR = 0% (n = 16); Score 1 = 5.3% (n = 48); Score 2 = 12% (n = 170); Score 3 = 14% (n = 146); and Score 4/5 = 25% (n = 54); (p = 0.008).The risk score was significantly associated with TVR rates and can be used as a simple clinical tool to identify those patients at a low risk for a new revascularization procedure.
- Published
- 2009