TY - JOUR
T1 - Value of Age, Creatinine, and Ejection Fraction (ACEF Score) in Assessing Risk in Patients Undergoing Percutaneous Coronary Interventions in the 'All-Comers' LEADERS Trial
AU - Wykrzykowska, Joanna J.
AU - Garg, Scot
AU - Onuma, Yoshinobu
AU - de Vries, Ton
AU - Goedhart, Dick
AU - Morel, Marie-Angele
AU - van Es, Gerrit-Anne
AU - Buszman, Pawel
AU - Linke, Axel
AU - Ischinger, Thomas
AU - Klauss, Volker
AU - Corti, Roberto
AU - Eberli, Franz
AU - Wijns, William
AU - Morice, Marie-Claude
AU - Di Mario, Carlo
AU - van Geuns, Robert Jan
AU - Juni, Peter
AU - Windecker, Stephan
AU - Serruys, Patrick W.
PY - 2011
Y1 - 2011
N2 - Background-The age, creatinine, and ejection fraction (ACEF) score (age/left ventricular ejection fraction+1 if creatinine >2.0 mg/dL) has been established as an effective predictor of clinical outcomes in patients undergoing elective coronary artery bypass surgery; however, its utility in "all-comer" patients undergoing percutaneous coronary intervention is yet unexplored. Methods and Results-The ACEF score was calculated for 1208 of the 1707 patients enrolled in the LEADERS trial. Post hoc analysis was performed by stratifying clinical outcomes at the 1-year follow-up according to ACEF score tertiles: ACEF(low) <= 1.0225, 1.0225 <ACEF(mid) <= 1.277, and ACEF(high) >1.277. At 1-year follow-up, there was a significantly lower number of patients with major adverse cardiac event-free survival in the highest tertile of the ACEF score ( ACEF(low) =92.1%, ACEF(mid) =89.5%, and ACEF(high) =86.1%; P=0.0218). Cardiac death was less frequent in ACEF(low) than in ACEF(mid) and ACEF(high) (0.7% vs 2.2% vs 4.5%; hazard ratio = 2.22, P=0.002) patients. Rates of myocardial infarction were significantly higher in patients with a high ACEF score (6.7% for ACEF(high) vs 5.2% for ACEF(mid) and 2.5% for ACEF(low); hazard ratio = 1.6, P = 0.006). Clinically driven target-vessel revascularization also tended to be higher in the ACEF(high) group, but the difference among the 3 groups did not reach statistical significance. The rate of composite definite, possible, and probable stent thrombosis was also higher in the ACEF(high) group ( ACEF(low) = 1.2%, ACEF(mid) =3.5%, and ACEF(high) =6.2%; hazard ratio=2.04, P <0.001). Conclusions-ACEF score may be a simple way to stratify risk of events in patients treated with percutaneous coronary intervention with respect to mortality and risk of myocardial infarction
AB - Background-The age, creatinine, and ejection fraction (ACEF) score (age/left ventricular ejection fraction+1 if creatinine >2.0 mg/dL) has been established as an effective predictor of clinical outcomes in patients undergoing elective coronary artery bypass surgery; however, its utility in "all-comer" patients undergoing percutaneous coronary intervention is yet unexplored. Methods and Results-The ACEF score was calculated for 1208 of the 1707 patients enrolled in the LEADERS trial. Post hoc analysis was performed by stratifying clinical outcomes at the 1-year follow-up according to ACEF score tertiles: ACEF(low) <= 1.0225, 1.0225 <ACEF(mid) <= 1.277, and ACEF(high) >1.277. At 1-year follow-up, there was a significantly lower number of patients with major adverse cardiac event-free survival in the highest tertile of the ACEF score ( ACEF(low) =92.1%, ACEF(mid) =89.5%, and ACEF(high) =86.1%; P=0.0218). Cardiac death was less frequent in ACEF(low) than in ACEF(mid) and ACEF(high) (0.7% vs 2.2% vs 4.5%; hazard ratio = 2.22, P=0.002) patients. Rates of myocardial infarction were significantly higher in patients with a high ACEF score (6.7% for ACEF(high) vs 5.2% for ACEF(mid) and 2.5% for ACEF(low); hazard ratio = 1.6, P = 0.006). Clinically driven target-vessel revascularization also tended to be higher in the ACEF(high) group, but the difference among the 3 groups did not reach statistical significance. The rate of composite definite, possible, and probable stent thrombosis was also higher in the ACEF(high) group ( ACEF(low) = 1.2%, ACEF(mid) =3.5%, and ACEF(high) =6.2%; hazard ratio=2.04, P <0.001). Conclusions-ACEF score may be a simple way to stratify risk of events in patients treated with percutaneous coronary intervention with respect to mortality and risk of myocardial infarction
U2 - https://doi.org/10.1161/CIRCINTERVENTIONS.110.958389
DO - https://doi.org/10.1161/CIRCINTERVENTIONS.110.958389
M3 - Article
C2 - 21205944
SN - 1941-7640
VL - 4
SP - 47
EP - 56
JO - Circulation. Cardiovascular interventions
JF - Circulation. Cardiovascular interventions
IS - 1
ER -