Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease

Lu Che, Li Xu, Yuguang Huang, Chunhua Yu Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive abi...

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Autores principales:	Che L, Xu L, Huang YG, Yu CH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Cardiovascular risk factors Older patient Coronary artery disease Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/e628a21743c1426da3df0faf0345e06f
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spelling	oai:doaj.org-article:e628a21743c1426da3df0faf0345e06f2021-12-02T00:27:22ZClinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease1178-1998https://doaj.org/article/e628a21743c1426da3df0faf0345e06f2017-12-01T00:00:00Zhttps://www.dovepress.com/clinical-utility-of-the-revised-cardiac-risk-index-in-older-chinese-pa-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Lu Che, Li Xu, Yuguang Huang, Chunhua Yu Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive ability of the RCRI in older Chinese patients with coronary artery disease (CAD) undergoing noncardiac surgery, which has not been previously evaluated.Methods: We performed a multicenter, prospective study. We enrolled a total of 1,202 patients, aged >60 years, with a history of CAD who underwent noncardiac surgery. Perioperative data were extracted from an electronic database. The primary end point was defined as an occurrence of a postoperative major cardiac event (PoMCE) within 30 days. Logistic regression analysis was performed to evaluate the performance of the RCRI. A modified RCRI was created and compared with the original RCRI with regard to its ability to predict postoperative cardiac events.Results: Of the enrolled patients, 4.3% experienced PoMCE. Most components of the RCRI were not predictive of postoperative cardiac events with the exception of insulin-dependent diabetes mellitus (odds ratio =2.38, 95% CI: 1.11–5.11; P=0.03). The RCRI performed no better than chance (area under the curve =0.53; 95% CI: 0.45–0.61) in identifying patients’ cardiac risk. The modified score had a higher discriminatory ability toward PoMCE (c index, 0.69 versus 0.53; P<0.01).Conclusion: The original RCRI shows poor predictive ability in Chinese patients with CAD undergoing noncardiac surgery. Keywords: cardiovascular risk factors, older patient, coronary artery disease, risk prediction modelChe LXu LHuang YGYu CHDove Medical PressarticleCardiovascular risk factorsOlder patientCoronary artery diseaseGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 35-41 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cardiovascular risk factors Older patient Coronary artery disease Geriatrics RC952-954.6
spellingShingle	Cardiovascular risk factors Older patient Coronary artery disease Geriatrics RC952-954.6 Che L Xu L Huang YG Yu CH Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
description	Lu Che, Li Xu, Yuguang Huang, Chunhua Yu Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive ability of the RCRI in older Chinese patients with coronary artery disease (CAD) undergoing noncardiac surgery, which has not been previously evaluated.Methods: We performed a multicenter, prospective study. We enrolled a total of 1,202 patients, aged >60 years, with a history of CAD who underwent noncardiac surgery. Perioperative data were extracted from an electronic database. The primary end point was defined as an occurrence of a postoperative major cardiac event (PoMCE) within 30 days. Logistic regression analysis was performed to evaluate the performance of the RCRI. A modified RCRI was created and compared with the original RCRI with regard to its ability to predict postoperative cardiac events.Results: Of the enrolled patients, 4.3% experienced PoMCE. Most components of the RCRI were not predictive of postoperative cardiac events with the exception of insulin-dependent diabetes mellitus (odds ratio =2.38, 95% CI: 1.11–5.11; P=0.03). The RCRI performed no better than chance (area under the curve =0.53; 95% CI: 0.45–0.61) in identifying patients’ cardiac risk. The modified score had a higher discriminatory ability toward PoMCE (c index, 0.69 versus 0.53; P<0.01).Conclusion: The original RCRI shows poor predictive ability in Chinese patients with CAD undergoing noncardiac surgery. Keywords: cardiovascular risk factors, older patient, coronary artery disease, risk prediction model
format	article
author	Che L Xu L Huang YG Yu CH
author_facet	Che L Xu L Huang YG Yu CH
author_sort	Che L
title	Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
title_short	Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
title_full	Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
title_fullStr	Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
title_full_unstemmed	Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease
title_sort	clinical utility of the revised cardiac risk index in older chinese patients with known coronary artery disease
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/e628a21743c1426da3df0faf0345e06f
work_keys_str_mv	AT chel clinicalutilityoftherevisedcardiacriskindexinolderchinesepatientswithknowncoronaryarterydisease AT xul clinicalutilityoftherevisedcardiacriskindexinolderchinesepatientswithknowncoronaryarterydisease AT huangyg clinicalutilityoftherevisedcardiacriskindexinolderchinesepatientswithknowncoronaryarterydisease AT yuch clinicalutilityoftherevisedcardiacriskindexinolderchinesepatientswithknowncoronaryarterydisease
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Clinical utility of the revised cardiac risk index in older Chinese patients with known coronary artery disease

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