Euroscore as predictor of in-hospital mortality after percutaneous coronary intervention

Objective To date, no common risk stratification system is available to predict the risk of surgical or percutaneous myocardial revascularization in patients with coronary artery disease (CAD). Thus, we sought to assess the European System for Cardiac Operative Risk Evaluation (EuroSCORE) validity to predict in-hospital mortality after percutaneous coronary intervention (PCI). Design, Setting and Participants EuroSCORE was prospectively and systematically assessed in 1173 consecutive patients undergoing PCI in a high-volume single centre between April 2005 and October 2006. Main Outcome Measure. Receiver operating characteristics (ROC) curve was used to describe performance and accuracy of the EuroSCORE risk model for the prediction of in-hospital mortality after PCI. Results The EuroSCORE model demonstrated an overall relationship between EuroSCORE rank and the incidence of in-hospital mortality, showing consistency in predicting patient risk across many subgroups and levels of global risk. At multivariable logistic regression analysis EuroSCORE value was an independent in-hospital mortality predictor (p=0.002) together with left main disease (p=0.005), procedural urgency (p=0.001), ACC/AHA C type lesion (p=0.02), and PCI failure (p=0.01). The area under the ROC curve for the EuroSCORE system was 0.91 (95% CI 0.86-0.97), indicating a good ability of the model to discriminate patients at risk of dying during the index hospitalization. Conclusion EuroSCORE risk model already extensively validated for the prediction of early mortality following open-heart surgery can be efficiently utilized also in the setting of PCI. The introduction of EuroSCORE assessment in patients with documented coronary artery disease may be useful to improve the revascularization strategy decision-making process.