ABSTRACT
OBJECTIVES: The aim of the study is to evaluate the predictive value of the model for end-stage liver disease (MELD) score for mortality in stable angina pectoris patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: We retrospectively analyzed 261 consecutive patients with stable angina pectoris who underwent CABG while not being on anticoagulant therapy. The patients were divided into two groups: survivors and non-survivors. The MELD score was calculated for all patients. The all-cause mortality within postoperative 12 months was the primary end point of the study. RESULTS: The follow-up period was 12 months. The non-survivors were older (72.0±6.1 vs 62.4±8.4, p<0.001). The MELD score was significantly higher in the non-survivors group (7.5±1.2 vs 6.7±0.7, p<0.001). The MELD score (p=0.001) was an independent predictor of postoperative one-year mortality. The addition of MELD score to EuroSCORE II significantly improved the prognostic performance of the EuroSCORE II (EuroSCORE II vs EuroSCORE II plus MELD score: AUCs: 0.792 vs 0.842). CONCLUSION: Our research showed that the MELD score could be useful to predict mortality in patients who have stable coronary artery disease, and are undergoing CABG surgery (Tab. 3, Fig. 2, Ref. 25).
Subject(s)
Coronary Artery Bypass , End Stage Liver Disease , Humans , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness IndexABSTRACT
OBJECTIVE: We aimed to determine whether the combination of a CHA2DS2-VASc score (C: Congestive Heart Failure, H: Hypertension, A2: Age ≥ 75 years, D: Diabetes mellitus, S: Stroke history, V: Vascular disease, A: Age ≥ 65 years, Sc: Sex category) and pre-percutaneous coronary intervention (PCI) thrombus load score was more sensitive at detecting the no-reflow phenomenon compared to the CHA2DS2-VASc score alone or to the thrombus load score alone in patients with acute ST-elevation myocardial infarction (STEMI) who had underwent primary PCI (PPCI). PATIENTS AND METHODS: 497 patients with acute STEMIs were divided into two groups: no-reflow group (n: 194) and control group (n: 303). The Thrombolysis In Myocardial Infarction (TIMI) flow grading and Myocardial Blush Grade (MBG) were used together to define angiographic no-reflow as TIMI flow < 3 (with any MBG grade) or TIMI flow 3 with MBG 0 or 1. Successful reperfusion was defined as TIMI flow 3 with MBG 2 or 3. RESULTS: CHA2DS2-VASc score was significantly higher in the no-reflow group than in the control group (2 [1-4] vs. 1 [0-3], p < 0.001]. Compared with the control group, the no-reflow group had a higher pre-PCI thrombus score (5 [4-5] vs. 4 [3-5], p = 0.001). Compared with the CHA2DS2-VASc score alone, the combined use of the pre-PCI thrombus score and the CHA2DS2-VASc score was associated with significant improvements in the ability to predict no-reflow (AUC) (0.65 vs. 0.60, p < 0.05). The addition of the pre-PCI thrombus score to the CHA2DS2-VASc score was related to a significant net reclassification improvement of 6.7% (p = 0.047) and an integrated discrimination improvement of 0.036 (p < 0.05). CONCLUSIONS: We have found that the combination of a CHA2DS2-VASc score and a pre-PCI thrombus load score was more sensitive in detecting the no-reflow phenomenon than only a CHA2DS2-VASc score in patients who underwent PPCIs for STEMIs.
