The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction

Abstract Background The CADILLAC risk score was developed to identify patients at low risk for adverse cardiovascular events following ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods We performed a single center retrospective review...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ryan S. Wilson, Peter Malamas, Brent Dembo, Sumeet K. Lall, Ninad Zaman, Brandon R. Peterson
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	ST segment elevation myocardial infarction Coronary artery disease Risk stratification Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/3a85ef91091546c086c405d7f4b3acf6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3a85ef91091546c086c405d7f4b3acf6
record_format	dspace
spelling	oai:doaj.org-article:3a85ef91091546c086c405d7f4b3acf62021-11-14T12:07:33ZThe CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction10.1186/s12872-021-02348-01471-2261https://doaj.org/article/3a85ef91091546c086c405d7f4b3acf62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02348-0https://doaj.org/toc/1471-2261Abstract Background The CADILLAC risk score was developed to identify patients at low risk for adverse cardiovascular events following ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods We performed a single center retrospective review of STEMI hospitalizations treated with PPCI from 2014 to 2018. Patients were stratified using the CADILLAC risk score into low risk, intermediate risk and high risk groups. Patients presenting with cardiac arrest or cardiogenic shock were excluded from the study. The primary outcome was adverse clinical events during initial hospitalization. Secondary outcomes were adverse clinical events at 30 days and 1 year following index hospitalization. Results The study included 341 patients. Compared to patients with a low CADILLAC score, adverse clinical events were similar in the intermediate risk group during hospitalization (OR 1.23, CI 0.37–4.05, p 0.733) and at 30 days (OR 2.27, CI 0.93–5.56, p 0.0733) while adverse clinical events were significantly elevated in the high risk group during hospitalization (OR 4.75, CI 1.91–11.84, p 0.0008) and at 30 days (OR 8.73, CI 4.02–18.96, p < 0.0001). At 1 year follow-up, compared to the low risk CADILLAC group (9.4% adverse clinical event rate), cumulative adverse clinical events were significantly higher in the intermediate risk group (22.9% event rate, OR 2.86, CI 1.39–5.89, p 0.0044) and in the elevated risk group (58.6% event rate, OR 13.67, CI 6.81–27.43, p < 0.0001). The mortality rate was 0% for patients defined at low risk by CADILLAC score during hospitalization, as well up to 1 year follow up. On receiver operating curve analysis, discrimination of in-hospital adverse clinical events was fair using CADILLAC (C = 0.66, odds ratio 1.18; 95% CI 1.04–1.33; p = 0.0064) with somewhat better discrimination at 30-day follow-up (C = 0.719) and 1-year follow-up (C = 0.715). Conclusion Patients defined as low risk by the CADILLAC score following a STEMI were associated with lower mortality and adverse clinical event rates during hospitalization and up to 1 year following STEMI when compared to those with an intermediate or high CADILLAC score.Ryan S. WilsonPeter MalamasBrent DemboSumeet K. LallNinad ZamanBrandon R. PetersonBMCarticleST segment elevation myocardial infarctionCoronary artery diseaseRisk stratificationDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ST segment elevation myocardial infarction Coronary artery disease Risk stratification Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	ST segment elevation myocardial infarction Coronary artery disease Risk stratification Diseases of the circulatory (Cardiovascular) system RC666-701 Ryan S. Wilson Peter Malamas Brent Dembo Sumeet K. Lall Ninad Zaman Brandon R. Peterson The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
description	Abstract Background The CADILLAC risk score was developed to identify patients at low risk for adverse cardiovascular events following ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods We performed a single center retrospective review of STEMI hospitalizations treated with PPCI from 2014 to 2018. Patients were stratified using the CADILLAC risk score into low risk, intermediate risk and high risk groups. Patients presenting with cardiac arrest or cardiogenic shock were excluded from the study. The primary outcome was adverse clinical events during initial hospitalization. Secondary outcomes were adverse clinical events at 30 days and 1 year following index hospitalization. Results The study included 341 patients. Compared to patients with a low CADILLAC score, adverse clinical events were similar in the intermediate risk group during hospitalization (OR 1.23, CI 0.37–4.05, p 0.733) and at 30 days (OR 2.27, CI 0.93–5.56, p 0.0733) while adverse clinical events were significantly elevated in the high risk group during hospitalization (OR 4.75, CI 1.91–11.84, p 0.0008) and at 30 days (OR 8.73, CI 4.02–18.96, p < 0.0001). At 1 year follow-up, compared to the low risk CADILLAC group (9.4% adverse clinical event rate), cumulative adverse clinical events were significantly higher in the intermediate risk group (22.9% event rate, OR 2.86, CI 1.39–5.89, p 0.0044) and in the elevated risk group (58.6% event rate, OR 13.67, CI 6.81–27.43, p < 0.0001). The mortality rate was 0% for patients defined at low risk by CADILLAC score during hospitalization, as well up to 1 year follow up. On receiver operating curve analysis, discrimination of in-hospital adverse clinical events was fair using CADILLAC (C = 0.66, odds ratio 1.18; 95% CI 1.04–1.33; p = 0.0064) with somewhat better discrimination at 30-day follow-up (C = 0.719) and 1-year follow-up (C = 0.715). Conclusion Patients defined as low risk by the CADILLAC score following a STEMI were associated with lower mortality and adverse clinical event rates during hospitalization and up to 1 year following STEMI when compared to those with an intermediate or high CADILLAC score.
format	article
author	Ryan S. Wilson Peter Malamas Brent Dembo Sumeet K. Lall Ninad Zaman Brandon R. Peterson
author_facet	Ryan S. Wilson Peter Malamas Brent Dembo Sumeet K. Lall Ninad Zaman Brandon R. Peterson
author_sort	Ryan S. Wilson
title	The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
title_short	The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
title_full	The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
title_fullStr	The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
title_full_unstemmed	The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction
title_sort	cadillac risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following st elevation myocardial infarction
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3a85ef91091546c086c405d7f4b3acf6
work_keys_str_mv	AT ryanswilson thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT petermalamas thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT brentdembo thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT sumeetklall thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT ninadzaman thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT brandonrpeterson thecadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT ryanswilson cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT petermalamas cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT brentdembo cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT sumeetklall cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT ninadzaman cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction AT brandonrpeterson cadillacriskscoreaccuratelyidentifiespatientsatlowriskforinhospitalmortalityandadversecardiovasculareventsfollowingstelevationmyocardialinfarction
_version_	1718429397422178304

The CADILLAC risk score accurately identifies patients at low risk for in-hospital mortality and adverse cardiovascular events following ST elevation myocardial infarction

Ejemplares similares