Defining Percutaneous Coronary Intervention Complexity and Risk An Analysis of the United Kingdom BCIS Database 2006-2016
Defining Percutaneous Coronary Intervention Complexity and Risk An Analysis of the United Kingdom BCIS Database 2006-2016
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DOI：
10.1016/j.jcin.2021.09.039
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发表时间：
2022-01-03
影响因子：
11.3
通讯作者：
Kinnaird, Tim
中科院分区：
文献类型：
--
作者：
Protty, Majd;Sharp, Andrew S. P.;Kinnaird, Tim
OBJECTIVES The authors used the BCIS (British Cardiovascular Intervention Society) database to define the factors associated with percutaneous coronary intervention (PCI) procedural complexity. BACKGROUND Complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly defined.METHODS The BCIS (British Cardiovascular Intervention Society) database was used to study all PCI procedures in the United Kingdom 2006-2016. A multiple logistic regression model was developed to identify variables associated with inhospital major adverse cardiac or cerebrovascular events (MACCE) and to construct a CHIP score. The cumulative effect of this score on patient outcomes was examined.RESULTS A total of 313,054 patients were included. Seven patient factors (age >= 80 years, female sex, previous stroke, previous myocardial infarction, peripheral vascular disease, ejection fraction 60 mm) were associated with increased in-hospital MACCE and defined as CHIP factors. The mean CHIP score/case for all PCIs increased significantly from 1.06 +/- 1.32 in 2006 to 1.49 +/- 1.58 in 2016 (P < 0.001 for trend). A CHIP score of 5 or more was present in 2.5% of procedures in 2006 increasing to 5.3% in 2016 (P < 0.001 for trend). Overall in-hospital MACCE was 0.6% when the CHIP score was 0 compared with 1.2% with any CHIP factor present (P < 0.001). As the CHIP score increased, an exponential increase in-hospital MACCE was observed. The cumulative MACCE for procedures associated with a CHIP score 4+ or above was 3.2%, and for a CHIP score 5+ was 4.4%. All other adverse clinical outcomes were more likely as the CHIP score increased.CONCLUSIONS Seven patient factors and 6 procedural factors were associated with adverse in-hospital MACCE and defined as CHIP factors. Use of a CHIP score might be a future target for risk modification. (C) 2022 by the American College of Cardiology Foundation.
