Stratification of patients

Oct 13, 2025 by wbrum.org 63 views

Risk PCI Score as a Predictor of Major Cardiovascular Events for 30 Days in Patients with Acute Myocardial Infarction of ST Segment Elevation Who Undergo Percutaneous Coronary Intervention at H. Adam Malik Hospital Medan Hospital

Introduction

Percutaneous coronary intervention (PCI) has become the primary strategy in revascularization for patients with acute myocardial infarction of ST segment elevation (STEMI). Despite the relatively low incidence of major cardiovascular events (MACE) after PCI, there are still cases where MACE can occur. In this context, PCI's risk scores are introduced as a new assessment system that aims to predict the possibility of MACE within 30 days after the PCI procedure in STEMI patients. This article aims to explore the prognostic capabilities of PCI risk scores as a post-PCI MACE prediction tool.

Background

Percutaneous coronary intervention (PCI) is a minimally invasive procedure used to open up blocked coronary arteries and restore blood flow to the heart. STEMI is a type of heart attack that occurs when the blood flow to the heart is completely blocked. PCI is often used to treat STEMI patients, but it is not without risks. MACE, which includes events such as death, myocardial infarction, and stroke, can occur after PCI. The risk of MACE is higher in patients with certain risk factors, such as age, sex, and comorbidities.

Methodology

In this study, as many as 72 samples of patients with a STEMI diagnosis undergoing PCI at H. Adam Malik Hospital Medan were included. During a follow-up period of 30 days, data regarding PCI risk scores and MACE events were recorded and analyzed. Univariate and bivariate analysis methods were used to assess the relationship between PCI risk scores and MACE events. Furthermore, the predictive value of the PCI risk score was analyzed using the ROC curve.

Results

Of the 72 patients registered in this study, as many as 30 subjects experienced MACE in a period of 30 days. Of the patients who experienced MACE, 86.7% were included in the high-risk category based on PCI risk scores. The results of the analysis showed a significant relationship between PCI risk scores and MACE events (p < 0.001). Based on ROC analysis, PCI's risk scores have a very strong prognostic ability in predicting MACE, with an AUC value of 91.9% (p < 0.001; 95% CI 0.86-0.978).

Discussion

The importance of this research cannot be ignored, because determining the risk in STEMI patients undergoing PCI is a crucial step in clinical management. By understanding the factors that affect the occurrence of MACE, the doctor can carry out a more precise intervention and minimize the risks that may be faced by patients.

The PCI risk score serves to identify patients with high risk which may require more stringent monitoring or additional post-PCI treatment. This has the potential to increase the patient's long-term results and reduce mortality and complications associated with cardiovascular conditions.

This study also highlighted the need for further research to confirm the findings and expand our understanding of risk factors related to STEMI. By deepening an understanding of the prognosis of STEMI patients through PCI risk scores, it is expected to increase the results of treatment and lead to a more personal treatment approach.

Conclusion

Overall, the findings of this study show that PCI risk scores are a very useful tool in clinical practice, especially in predicting MACE events after PCI intervention. The use of PCI risk scores can help in better clinical decision making and provide more effective care for patients with acute myocardial infarction.

Recommendations

Based on the findings of this study, the following recommendations are made:

Use of PCI risk scores: PCI risk scores should be used as a tool to predict the possibility of MACE in STEMI patients undergoing PCI.
Stratification of patients: Patients with high-risk PCI scores should be stratified and receive more stringent monitoring or additional post-PCI treatment.
Further research: Further research is needed to confirm the findings and expand our understanding of risk factors related to STEMI.
Personalized treatment approach: A more personalized treatment approach should be adopted based on the patient's risk profile and PCI risk score.

Limitations

This study has several limitations, including:

Small sample size: The sample size of this study was relatively small, which may limit the generalizability of the findings.
Single-center study: This study was conducted at a single center, which may limit the external validity of the findings.
Short follow-up period: The follow-up period of this study was relatively short, which may not capture the long-term effects of PCI on MACE.

Future Directions

Future studies should aim to:

Confirm the findings: Confirm the findings of this study in a larger and more diverse population.
Expand our understanding of risk factors: Expand our understanding of risk factors related to STEMI and their impact on MACE.
Develop a more personalized treatment approach: Develop a more personalized treatment approach based on the patient's risk profile and PCI risk score.

Conclusion

In conclusion, this study demonstrates the prognostic capabilities of PCI risk scores as a post-PCI MACE prediction tool. The use of PCI risk scores can help in better clinical decision making and provide more effective care for patients with acute myocardial infarction. Further research is needed to confirm the findings and expand our understanding of risk factors related to STEMI.
Frequently Asked Questions (FAQs) about Risk PCI Score as a Predictor of Major Cardiovascular Events

Q: What is a Risk PCI Score?

A: A Risk PCI Score is a new assessment system that aims to predict the possibility of Major Cardiovascular Events (MACE) within 30 days after the PCI procedure in STEMI patients.

Q: What is STEMI?

A: STEMI stands for ST-Elevation Myocardial Infarction, which is a type of heart attack that occurs when the blood flow to the heart is completely blocked.

Q: What is PCI?

A: PCI stands for Percutaneous Coronary Intervention, which is a minimally invasive procedure used to open up blocked coronary arteries and restore blood flow to the heart.

Q: What are Major Cardiovascular Events (MACE)?

A: MACE includes events such as death, myocardial infarction, and stroke.

Q: How does the Risk PCI Score work?

A: The Risk PCI Score is calculated based on various factors, including age, sex, comorbidities, and other risk factors. The score is then used to predict the possibility of MACE within 30 days after the PCI procedure.

Q: What are the benefits of using the Risk PCI Score?

A: The use of the Risk PCI Score can help in better clinical decision making and provide more effective care for patients with acute myocardial infarction. It can also help identify patients with high risk who may require more stringent monitoring or additional post-PCI treatment.

Q: What are the limitations of the Risk PCI Score?

A: The Risk PCI Score has several limitations, including a small sample size, single-center study, and short follow-up period. Further research is needed to confirm the findings and expand our understanding of risk factors related to STEMI.

Q: Can the Risk PCI Score be used in other populations?

A: The Risk PCI Score was developed specifically for STEMI patients undergoing PCI. However, it may be possible to adapt the score for use in other populations, such as patients with non-ST-elevation myocardial infarction (NSTEMI) or stable angina.

Q: How can healthcare providers use the Risk PCI Score in clinical practice?

A: Healthcare providers can use the Risk PCI Score as a tool to predict the possibility of MACE in STEMI patients undergoing PCI. They can also use the score to stratify patients and provide more targeted treatment.

Q: What are the next steps for research on the Risk PCI Score?

A: Further research is needed to confirm the findings and expand our understanding of risk factors related to STEMI. This may include larger and more diverse studies, as well as studies that explore the use of the Risk PCI Score in other populations.

Q: How can patients benefit from the use of the Risk PCI Score?

A: Patients can benefit from the use of the Risk PCI Score by receiving more targeted and effective treatment. They can also benefit from more precise monitoring and follow-up care.

Q: What are the potential implications of the Risk PCI Score for healthcare policy and practice?

A: The Risk PCI Score has the potential to improve healthcare outcomes and reduce costs by providing more targeted and effective treatment for STEMI patients. It may also lead to changes in healthcare policy and practice, such as the use of risk-based stratification and more personalized treatment approaches.