Application of the New York State PTCA mortality model in patients undergoing stent implantation

This study applied the New York State conventional coronary angioplasty (PTCA) model of clinical outcomes to evaluate whether it has relevance in the current era of stent implantation. The model was developed in 62 670 patients treated with conventional PTCA from 1991 to 1994 to risk adjust mortalit...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2000-08, Vol.102 (5), p.517-522
Main Authors: HOLMES, D. R, BERGER, P. B, GARRATT, K. N, MATHEW, V, BELL, M. R, BARSNESS, G. W, HIGANO, S. T, GRILL, D. E, HAMMES, L. N, RIHAL, C. S
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary - mortality
Biological and medical sciences
Coronary Artery Bypass
Diseases of the cardiovascular system
Female
Follow-Up Studies
Graft Occlusion, Vascular - mortality
Graft Occlusion, Vascular - therapy
Humans
Male
Medical sciences
Middle Aged
Models, Statistical
New York
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk Assessment
Risk Factors
Stents - adverse effects
Treatment Outcome
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Summary:This study applied the New York State conventional coronary angioplasty (PTCA) model of clinical outcomes to evaluate whether it has relevance in the current era of stent implantation. The model was developed in 62 670 patients treated with conventional PTCA from 1991 to 1994 to risk adjust mortality and bypass surgery after PTCA. Since then, stents have become the dominant form of intervention. Whether that model remains relevant is uncertain. All patients undergoing stenting at the Mayo Clinic from 1995 to 1998 were analyzed for in-hospital mortality, bypass surgery performed after attempted stenting, and longer-term mortality. No patients were excluded. The New York model was used to risk adjust and predict in-hospital and follow-up mortality. There were 3761 patients with 4063 procedural admissions for stenting; 6,472 target vessel segments were attempted, and 96.1% of procedures were successful. With the New York multivariable risk factor equation, 79 in-hospital deaths were expected (1.95%); 66 deaths (1.62%) were observed. The New York model risk score in a logistic regression model was the most significant factor associated with in-hospital mortality (OR, 1.86; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.102.5.517