Risk factor score for predicting in-hospital adverse cardiovascular events in elderly patients undergoing percutaneous coronary intervention / 第二军医大学学报

ABSTRACT

Objective To identify the risk factors of in-hospital adverse cardiovascular events in elderly patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) and to establish a risk factor score for these CAD patients. Methods A total of 1 007 consecutive elderly patients with coronary heart disease, aged over 75 years old, who underwent PCI in our hospital from January 2005 to December 2010, were enrolled in this study. Univariate and multivariate logistic regression analysis were performed to determine the risk factors associated with adverse cardiovascular events, and then a risk score model was constructed according to the analysis results. The risk score model was then validated with 527 elderly CAD patients over 75 years old who underwent PCI in our hospital between January 2011 and December 2012. The area under the receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness of fit data were calculated to assess the performance and calibration of this risk score. Results Multivariate logistic regression analysis indicated 7 independent predictors with their associated risk weights as follows urgent PCI (3 scores), renal insufficiency (2 scores), left main disease (2 scores), diabetes mellitus (1 score), acute myocardial infarction (1 score), type C lesion (1 score), and ≥3 stents placed (1 score). The validation results showed that the risk score model had a good performance in terms of discrimination and calibration, with the area under ROC curve being 0.89 and Hosmer-Lemeshow P value being 0.586. Conclusion Finally 7 risk factors are included for the risk score model, with the risk factor scores of each ranging 1-3 and the highest total score being 11. The constructed score model can accurately predict the adverse cardiovascular events in elderly CAD patients undergoing PCI.