Validation of the Prognostic Ability of Eight Risk Scores for Cardiovascular Events in NSTEMI Patients with Multi-Vessel Disease

Abstract

This study compared eight risk scores regarding their predictive ability in non-ST-elevation myocardial infarction (NSTEMI) patients (n = 862) with multi-vessel disease (MVD) after percutaneous coronary intervention (PCI). The primary outcome was cardiac death. The secondary outcomes included major adverse cardiovascular event (MACE) [a composite of all-cause death, myocardial infarction (MI), and unplanned repeat revascularization], all-cause death, and MI. During a median follow-up of 4.8 years, 47 (5.5%) cardiac death, 218 (25.3%) MACE, 79 (9.2%) all-cause death, and 40 (4.6%) MI were recorded. The Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score II was the most accurate for cardiac death with the highest area under the receiver operating characteristic curve (AUC) (0.814, 95% CI: 0.758–0.869). The logistic SYNTAX score extended model (LSS_extended) exhibited the most powerful ability in predicting MACE (AUC: 0.624, 95% CI: 0.580–0.667) and MI (AUC: 0.657, 95% CI: 0.567–0.747). The modified Age, Creatinine, and Ejection Fraction score (MAS) was the most accurate score in predicting all-cause death (AUC: 0.798, 95% CI: 0.752–0.844). The scores involving clinical variables showed better ability to predict adverse cardiovascular events among NSTEMI patients with MVD after PCI.