PLoS ONE (Jan 2015)

Angiographic Lesion Complexity Score and In-Hospital Outcomes after Percutaneous Coronary Intervention.

  • Ayaka Endo,
  • Akio Kawamura,
  • Hiroaki Miyata,
  • Shigetaka Noma,
  • Masahiro Suzuki,
  • Takashi Koyama,
  • Shiro Ishikawa,
  • Susumu Nakagawa,
  • Shunsuke Takagi,
  • Yohei Numasawa,
  • Keiichi Fukuda,
  • Shun Kohsaka,
  • JCD-KICS Investigators

DOI
https://doi.org/10.1371/journal.pone.0127217
Journal volume & issue
Vol. 10, no. 6
p. e0127217

Abstract

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We devised a percutaneous coronary intervention (PCI) scoring system based on angiographic lesion complexity and assessed its association with in-hospital complications.Although PCI is finding increasing application in patients with coronary artery disease, lesion complexity can lead to in-hospital complications.Data from 3692 PCI patients were scored based on lesion complexity, defined by bifurcation, chronic total occlusion, type C, and left main lesion, along with acute thrombus in the presence of ST-segment elevation myocardial infarction (1 point assigned for each variable).The patients' mean age was 67.5 +/- 10.8 years; 79.8% were male. About half of the patients (50.3%) presented with an acute coronary syndrome, and 2218 (60.1%) underwent PCI for at least one complex lesion. The patients in the higher-risk score groups were older (p 3.0 g/dL (3.1%, 11.0%, 13.1%, 10.3%, 28.6%, p < 0.001); and postoperative myocardial infarction (1.5%, 3.1%, 3.8%, 3.8%, 10%, p = 0.004), respectively. The association with adverse outcomes persisted after adjustment for known clinical predictors (odds ratio 1.72, p < 0.001).The complexity score was cumulatively associated with in-hospital mortality and complication rate and could be used for event prediction in PCI patients.