Compassionate Use Variables Improve Mortality Risk Prediction for Percutaneous Coronary Intervention

The rate of critically ill PCI recipients increased after neurologic and functional covariates were incorporated into the risk-adjustment model.

Public reporting of risk-adjusted mortality might deter physicians from performing percutaneous coronary intervention (PCI), particularly in high-risk patients. To find out more, Massachusetts investigators studied the effect of adding three new “compassionate use” (CU) variables — coma on presentation, active hemodynamic support during PCI, and cardiopulmonary resuscitation at PCI initiation — to current risk-prediction models. Data were collected from an inclusive state registry of almost 30,000 first PCI procedures at all nonfederal hospitals during 2005–2007, including 5588 patients with cardiogenic shock or ST-segment-elevation myocardial infarction (STEMI).

A CU attribute was present in 1.7% of PCI recipients with cardiogenic shock or …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI