PP.01.08

Abstract

Objective: It is well known that patients with coronary artery bypass surgery (CABS) have physiological changes in coronary artery structure. In these patients, risk factors for coronary artery disease have different influence of new coronary events expression, than in patients without CABS. Acute myocardial infarction (AMI) is one of the most important major adverse cardiovascular events (MACE) in patients after previous CABS. This substudy aimed at evaluating the usefulness of the POP-HT score (PostOperative Prognosis-HyperTension score), originally developed for the prediction of 60-day, 1-year, 5-year, 10-year, 15-year and 20-year MACE, after CABS in patients with hypertension (HT). Design and method: From April 1988, we analyzed 2014 consecutive patients with HT who underwent CABS. Expression of AMI was the predefined end point. Models discrimination and calibration to predict AMI was tested using receiver-operating characteristics curves and the goodness-of-fit (GoF) test. Sensitivity analyses and 1000-resample bootstrapping were used to evaluate the model's performance. Results: The rate of AMI was 32.6 %, respectively. Compared with controls, the cumulative AMI group was associated with much higher rates of adverse clinical outcomes at 60-day follow-up (adjusted odds ratio (OR) for death 7.22), at 1-year follow-up (adjusted OR for death 7.38), at 5-year follow-up (adjusted OR for death 7.66), at 10-year follow-up (adjusted OR for death 7.95), at 15-year follow-up (adjusted OR for death 8.20) and at 20-year follow-up (adjusted OR for death 8.32). Internal validation confirmed a reasonably good discrimination and calibration of the POP-HT score for the prediction of AMI (area under the curve (AUC) 0.68, GoF 0.34), after CABS in patients with HT. Conclusions: The risk of AIM in patients with HT, after previous CABS, could be accurately assessed using the POP-HT score, which might help in deciding upon measures aimed at preventing adverse prognosis.