Development of a Novel BifurcAID Risk Score to Predict MACE Following Coronary True Bifurcation Intervention

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions Pub Date : 2025-03-24 DOI:10.1016/j.jcin.2024.11.034

Shingo Minatoguchi MD , Anoop N. Koshy MBBS, PhD , Yuliya Vengrenyuk PhD , Manish Vinayak MD , Keisuke Yasumura MD , Raman Sharma MD , Parasuram Krishnamoorthy MD , Javed Suleman MD , Joseph Sweeny MD , Amit Hooda MD , Vishal Kapur MD , Roxana Mehran MD , Samin K. Sharma MD , Annapoorna S. Kini MD

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引用次数: 0

Abstract

Background

Percutaneous coronary intervention (PCI) for true bifurcation lesions is associated with a higher risk of adverse clinical events.

Objectives

This study sought to establish a point-based score using clinical and angiographic characteristics in true bifurcation lesions before PCI to predict the risk of major adverse cardiovascular events (MACE).

Methods

A total of 1,896 consecutive patients undergoing PCI for true bifurcation lesions between 2012 and 2019 in our institution were included. All angiograms were reviewed by an independent core laboratory for classification of the bifurcation lesions. A multivariate model identified factors associated with 1-year MACE, comprising all-cause death, myocardial infarction, and target vessel revascularization. Points were assigned to each risk factor proportional to their regression coefficients to create a cumulative risk score. The score was used to stratify patients into low-, intermediate-, and high-risk cohorts.

Results

At 1-year post-PCI, MACE occurred in 185 patients (9.8%). Eleven predictors of MACE were identified: 5 clinical (insulin-dependent diabetes mellitus, left ventricular ejection fraction ≤30%, non–ST-segment elevation myocardial infarction presentation, age >80 years, and non-white race/ethnicity), and 6 angiographic (left main or left circumflex-obtuse marginal coronary artery lesion, multivessel disease, side branch [SB] thrombus, SB moderate/severe calcium, and SB lesion length >10 mm). The rate of MACE was 4.9% in low-risk patients with a risk score 0 to 6 (reference group), 12.9% in intermediate-risk patients with a score 7 to 9 (OR: 2.63; 95% CI: 1.74-3.98; P < 0.001), and 25.4% in high-risk group with a score ≥10 (OR: 5.18; 95% CI: 3.56-7.53; P < 0.001).

Conclusions

The BifurcAID risk score may facilitate risk stratification among patients undergoing true bifurcation PCI and guide patient-tailored treatment strategies.

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来源期刊

JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

8.80%

发文量

756

审稿时长

4-8 weeks

期刊介绍： JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.