Clinical implications of the MELD-XI score in patients undergoing percutaneous coronary intervention: Insights from the SAKURA PCI2 Antithrombotic registry

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-03-11 DOI:10.1016/j.ijcha.2025.101645

Mitsumasa Sudo , Riku Arai , Keisuke Kojima , Eizo Tachibana , Wataru Atsumi , Michiaki Matsumoto , Naoya Matsumoto , Kazumiki Nomoto , Takaaki Kogo , Ken Arima , Masaru Arai , Yutaka Koyama , Koji Oiwa , Hironori Haruta , Yasuo Okumura

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Abstract

Background

The association between hepatorenal function, assessed by the Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, and clinical prognosis remains unclear in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to evaluate the clinical implications of the MELD-XI score.

Methods

Consecutive patients who underwent PCI from June 2020 to September 2022 in the SAKURA PCI2 Antithrombotic registry, a multi-center observational prospective cohort study, were reviewed. Patients with missing data for calculating the MELD-XI score were excluded. Study participating patients were stratified into two groups based on the MELD-XI score: high (>10) and low (≤10). The primary outcome was defined as two-year all-cause mortality. The secondary outcome was defined as major bleeding in accordance with the Bleeding Academic Research Consortium 3 or 5.

Results

Among 1064 patients, 265 (24.9 %) were stratified into a high MELD-XI score. Patients with a high MELD-XI had higher two-year all-cause mortality than those with a low MELD-XI score (19.6 % vs. 4.7 %, log-rank p < 0.01). This association was supported in the multivariable analysis (adjusted HR 3.26, 95 %CI 1.84–5.75, p < 0.01) and further supported by spline curve analysis. A high MELD-XI score was also associated with an increased risk of major bleeding (adjusted HR 2.94, 95 %Ci 1.55–5.56, p < 0.01).

Conclusions

A high MELD-XI score was associated with an increased risk of all-cause mortality and major bleeding within two years. Therefore, the MELD-XI score could provide valuable additional information for risk stratification in patients undergoing PCI.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.