1 Halkin A, Singh M, Nikolsky N, et al. Prediction of Mortality After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: The CADILLAC Risk Score. JACC 2005;45:1397-1405.
2 Weintraub W, Grau-Sepulveda M, Weiss J, et al. Prediction of Long-Term Mortality After Percutaneous Coronary Intervention in Older Adults: Results From the National Cardiovascular Data Registry. Circulation 2012;125:1501-1510.
3 Solomon SD, Zelenkofske S, McMurray JV, et al. Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both. NEJM 2005;352:2581-2588.
4 Zishiri ET, Williams S, Cronin EM. Early Risk of Mortality After Coronary Artery Revascularization in Patients With Left Ventricular Dysfunction and Potential Role of the Wearable Cardioverter Defibrillator. Circ Arrhythm Electrophysiol. 2013;6: 117-128.
5 Adabag AS, Therneau TM, Gersh BJ, et al. Sudden Death After Myocardial Infarction. JAMA 2008;300(17):2022-2029.
6 Buxton AE, Lee KL, Hafley GE, et al. Limitations of Ejection Fraction for Prediction of Sudden Death Risk in Patients with Coronary Artery Disease: Lessons From the MUSTT Study. J. Am. Coll. Cardiol. 2007;50;1150-1157.
7 Stone G, Rao SV, Hermiller JB, et al. “Prevention of Sudden Cardiac Arrest Post PTCA in High-Risk Patients.” April 2011. Available at http://www.theheart.org/article/1202823.do.
A core set of factors have been consistently shown to be predictors of mortality following revascularization in the short term.
You Selected: LOW RISK
Actual Patient Risk: HIGH
This patient is at High risk of mortality, particularly in the early period post-PCI, based on the risk factors identified:
- Age ≥ 65 years 1,2,5,6
- Renal Insufficiency 1
- Diabetes 5,7
- Hypertension 5
- Killip Class 2 or 3 1,5
- LVEF ≤ 35% 1,2,3,4
- Multi-vessel Disease 1,2,3,4
- Previous MI 3
- Anemia 1
- TIMI Flow 0-2 1
Following a PCI procedure, 1 in 5 patients have been shown to be at high risk of early mortality.1 In post-PCI patients with a low EF (≤35%), 3 month mortality is 13%4, and increases significantly in the presence of other risk factors.2
It has been found that 60% of mortality in high risk patients is due to sudden cardiac death.7
