A new simplified prognostic score with a cutoff of ≥5 or ≥6 points successfully identified a higher risk of cardiovascular death (p=0.015 and p=0.012, respectively) in stable coronary disease.
RCT (n=372)
randomized
p-value: p=0.015 and 0.012
BACKGROUND: The need to improve the exercise testing accuracy, pushed the development of scores, whose applicability was already broadly recognized. OBJECTIVE: Prognostic evaluation of stable coronary disease through a new simplified score. METHODS: A new score was applied in 372 multivessel coronary patients with preserved ventricular function, 71.8% male, age: 59.5 (± 9.07) years old, randomized to medical treatment, surgery (CABG) or angioplasty (PTCA), with 5 years of follow-up. Cardiovascular death was considered the primary endpoint. Non-fatal myocardial infarction, death and re-intervention were considered for a combined secondary endpoint. The score was based on an equation previously validated, resulting from a sum of one point for: male gender, infarction history, angina, diabetes, insulin use and one point for each decade of life after 40 years old. Positive exercise testing summed one additional point. RESULTS: Thirty six deaths was observed (10 in group PTCA, 15 in CABG and 11 in the clinical group), p = 0.61. We observed 93 combined events: 37 in PTCA group, 23 in CABG and 33 in the clinical group (p = 0.058). 247 patients presented clinical score ≥ 5 points and 216 ≥ 6 points. The cutoff point ≥ 5 or ≥ 6 points identified higher risk, p = 0.015 and p = 0.012, respectively. The survival curve showed a different death incidence after the randomization when score reached 06 points or more (p = 0.07), and a distinct incidence of combined events between the patients with score < 6 and ≥ 6 points (p = 0.02). CONCLUSION: The new score was consistent for multiarterial stable coronary disease risk stratification.
Storti et al. (Sun,) conducted a rct in Stable coronary disease (n=372). New simplified prognostic score vs. Score < 5 or < 6 points was evaluated on Cardiovascular death (p=0.015 and 0.012). A new simplified prognostic score with a cutoff of ≥5 or ≥6 points successfully identified a higher risk of cardiovascular death (p=0.015 and p=0.012, respectively) in stable coronary disease.