Abstract 18677: The ACEF Risk Score Exhibits Superior Predictive Ability for Adverse Clinical Outcomes in Women Undergoing PCI
Objectives: Women are known to experience worse clinical outcomes than men following percutaneous coronary intervention (PCI). Rather than a gender-specific effect, this is believed to be due to a greater burden of baseline cardiovascular risk factors. We therefore sought to identify which of the commonly used risk scores identify female patients at particular risk for adverse clinical events following PCI.
Methods: Patients with triple vessel and/or LM disease with 12 month follow-up were studied from our single center PCI registry (n=584; mean age 69.8±12.3). Exclusion criteria included STEMI presentation, prior revascularization, and shock. Clinical events at 12 months were compared to baseline risk scores, based on area under the receiver operating characteristic curves (AUC; all comparisons females vs. males, respectively). The following scores were evaluated and compared: SYNTAX risk score (SRS), ACEF, modified ACEF (ACEFmod), NCDR, Clinical SYNTAX score (CSS), and NY State Risk Score (NYSRS).
Results: Women (n=179, 30.7%), were older (75.8±10.6 vs. 67.2±12.2; p≤0.0001) and more often presented with CCS class III/IV angina. The SRS was the only risk score for which women and men had similar scoresvalues; for all other scores women had significantly higher scores values than men. For mortality, the ACEF score was the only score to show significantly better predictive ability in females (AUC 0.85 vs. 0.70; p<0.05) (Figure). For myocardial infarction, both the ACEF (0.79 vs. 0.49; p<0.005) and NYSRS (0.75 vs. 0.48; p<0.05) showed superior predictive ability in females. No score demonstrated gender specificity for TLR. For overall MACE (mortality+MI+TLR), the ACEF score was the only score with greater predictive ability in females versus males (0.69 vs. 0.56; p<0.05) (Figure).
Conclusions: The ACEF score is simple to calculate (using only Age, Creatinine and Ejection Fraction) and offers superior clinical outcome prediction in females undergoing PCI.
- © 2012 by American Heart Association, Inc.