Risk assessment of remotely fatal cardiovascular events after elective percutaneous coronary intervention

Abstract

Highlights. The frequency of long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective (non-emergency) percutaneous coronary interventions was estimated.Risk stratification model of long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective percutaneous coronary interventions has been created.Aim. To determine the frequency of long-term fatal cardiovascular events (CVE) after elective percutaneous coronary interventions (PCI) and to develop a model for stratifying the risk of these events.Methods. 150 patients with chronic coronary syndrome and indications for endovascular myocardial revascularization were included in the research. After PCI the patients were observed on an outpatient basis for year. The frequency of fatal cardiovascular complications was estimated by telephone interview 6 years after the index intervention.Results. Survival in the study group after 6 years was 86.1%. Fatal CVEs were reported in 10.6% of patients. The following baseline variables were significant predictors of cardiovascular death included in the individual risk assessment model: NYHA functional class of chronic heart failure (odds ratio (OR) 0.06, 95% confidence interval (CI) 0.003-1.106), lean plasma glucose level (OR 0.07, 95% CI 0.12-0.43), atrial fibrillation (OR 43.1, 95% CI 2.01–922.01), as well as the value of creatinine in the blood one year after the intervention (OR 1.14, 95% CI 1.0–1.3) and glomerular filtration rate (CKD-EPI) (OR 1.4, 95% CI 1.09–1.81). The area under the curve (AUC) of the developed model was 0.976 [95% CI 0,000–1,000].Conclusion. The proposed risk stratification model of developing long-term fatal cardiovascular complications in patients with chronic coronary syndrome subjected to selective (non-emergency) PCI allows identifying patients with an unfavorable long-term (six-year) prognosis.