Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Different ways have been used to stratify risk in acute coronary syndrome (ACS) patients. The aim of the study was to examine the usefulness of echocardiographic parameters as predictors of in-hospital outcome in patients with ACS after percutaneous coronary intervention (PCI). A data of 2030 patien...

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Main Authors: Miroslava Sladojevic, Srdjan Sladojevic, Dubravko Culibrk, Snezana Tadic, Robert Jung
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2014/818365
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author Miroslava Sladojevic
Srdjan Sladojevic
Dubravko Culibrk
Snezana Tadic
Robert Jung
author_facet Miroslava Sladojevic
Srdjan Sladojevic
Dubravko Culibrk
Snezana Tadic
Robert Jung
author_sort Miroslava Sladojevic
collection DOAJ
description Different ways have been used to stratify risk in acute coronary syndrome (ACS) patients. The aim of the study was to examine the usefulness of echocardiographic parameters as predictors of in-hospital outcome in patients with ACS after percutaneous coronary intervention (PCI). A data of 2030 patients with diagnosis of ACS hospitalized from December 2008 to December 2011 was used to develop a risk model based on echocardiographic parameters using the binary logistic regression. This model was independently evaluated in validation cohort prospectively (954 patients admitted during 2012). In-hospital mortality in derivation cohort was 7.73%, and 6.28% in validation cohort. Developed model has been designed with 4 independent echocardiographic predictors of in-hospital mortality: left ventricular ejection fraction (LVEF RR =0.892; 95%CI =0.854–0.932, P<0.0005), aortic leaflet separation diameter (AOvs RR =0.131; 95%CI =0.027–0.627, P=0.011), right ventricle diameter (RV RR =2.675; 95%CI =1.109–6.448, P=0.028) and right ventricle systolic pressure (RVSP RR =1.036; 95%CI =1.000–1.074, P=0.048). Model has good prognostic accuracy (AUROC =0.84) and it retains good (AUROC =0.78) when testing on the validation cohort. Risks for in-hospital mortality after PCI in ACS patients using echocardiographic measurements could be accurately predicted in contemporary practice. Incorporation of such developed model should facilitate research, clinical decisions, and optimizing treatment strategy in selected high risk ACS patients.
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spelling doaj-art-b0ea553b34f4438bbd8ae741b3b57fbd2025-02-03T06:06:23ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/818365818365Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary InterventionMiroslava Sladojevic0Srdjan Sladojevic1Dubravko Culibrk2Snezana Tadic3Robert Jung4Institute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, SerbiaDepartment for Telecommunications and Signal Processing, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovica 6, 21000 Novi Sad, SerbiaDepartment for Industrial Engineering and Management, Faculty of Technical Sciences, University of Novi Sad, Trg Dositeja Obradovica 6, 21000 Novi Sad, SerbiaInstitute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, SerbiaInstitute of Cardiovascular Diseases Vojvodina, Put Doktora Goldmana 4, 21208 Sremska Kamenica, SerbiaDifferent ways have been used to stratify risk in acute coronary syndrome (ACS) patients. The aim of the study was to examine the usefulness of echocardiographic parameters as predictors of in-hospital outcome in patients with ACS after percutaneous coronary intervention (PCI). A data of 2030 patients with diagnosis of ACS hospitalized from December 2008 to December 2011 was used to develop a risk model based on echocardiographic parameters using the binary logistic regression. This model was independently evaluated in validation cohort prospectively (954 patients admitted during 2012). In-hospital mortality in derivation cohort was 7.73%, and 6.28% in validation cohort. Developed model has been designed with 4 independent echocardiographic predictors of in-hospital mortality: left ventricular ejection fraction (LVEF RR =0.892; 95%CI =0.854–0.932, P<0.0005), aortic leaflet separation diameter (AOvs RR =0.131; 95%CI =0.027–0.627, P=0.011), right ventricle diameter (RV RR =2.675; 95%CI =1.109–6.448, P=0.028) and right ventricle systolic pressure (RVSP RR =1.036; 95%CI =1.000–1.074, P=0.048). Model has good prognostic accuracy (AUROC =0.84) and it retains good (AUROC =0.78) when testing on the validation cohort. Risks for in-hospital mortality after PCI in ACS patients using echocardiographic measurements could be accurately predicted in contemporary practice. Incorporation of such developed model should facilitate research, clinical decisions, and optimizing treatment strategy in selected high risk ACS patients.http://dx.doi.org/10.1155/2014/818365
spellingShingle Miroslava Sladojevic
Srdjan Sladojevic
Dubravko Culibrk
Snezana Tadic
Robert Jung
Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
The Scientific World Journal
title Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
title_full Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
title_fullStr Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
title_full_unstemmed Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
title_short Echocardiographic Parameters as Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
title_sort echocardiographic parameters as predictors of in hospital mortality in patients with acute coronary syndrome undergoing percutaneous coronary intervention
url http://dx.doi.org/10.1155/2014/818365
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