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Defining Percutaneous Coronary Intervention Complexity and Risk: An Analysis of the United Kingdom BCIS Database 2006-2016.

Title: Defining Percutaneous Coronary Intervention Complexity and Risk: An Analysis of the United Kingdom BCIS Database 2006-2016.
Authors: Protty, M; Sharp, ASP; Gallagher, S; Farooq, V; Spratt, JC; Ludman, P; Anderson, R; McEntegart, MM; Hanratty, C; Walsh, S; Curzen, N; Smith, E; Mamas, MA; Kinnaird, T
Publisher Information: Elsevier
Publication Year: 2022
Collection: Keele University: Keele Research Repository
Subject Terms: R Medicine (General)
Description: OBJECTIVES: The authors used the BCIS (British Cardiovascular Intervention Society) database to define the factors associated with percutaneous coronary intervention (PCI) procedural complexity. BACKGROUND: Complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) is an emerging concept that is poorly defined. METHODS: The BCIS (British Cardiovascular Intervention Society) database was used to study all PCI procedures in the United Kingdom 2006-2016. A multiple logistic regression model was developed to identify variables associated with in-hospital major adverse cardiac or cerebrovascular events (MACCE) and to construct a CHIP score. The cumulative effect of this score on patient outcomes was examined. RESULTS: A total of 313,054 patients were included. Seven patient factors (age ≥80 years, female sex, previous stroke, previous myocardial infarction, peripheral vascular disease, ejection fraction 60 mm) were associated with increased in-hospital MACCE and defined as CHIP factors. The mean CHIP score/case for all PCIs increased significantly from 1.06 ± 1.32 in 2006 to 1.49 ± 1.58 in 2016 (P < 0.001 for trend). A CHIP score of 5 or more was present in 2.5% of procedures in 2006 increasing to 5.3% in 2016 (P < 0.001 for trend). Overall in-hospital MACCE was 0.6% when the CHIP score was 0 compared with 1.2% with any CHIP factor present (P < 0.001). As the CHIP score increased, an exponential increase in-hospital MACCE was observed. The cumulative MACCE for procedures associated with a CHIP score 4+ or above was 3.2%, and for a CHIP score 5+ was 4.4%. All other adverse clinical outcomes were more likely as the CHIP score increased. CONCLUSIONS: Seven patient factors and 6 procedural factors were associated with adverse in-hospital MACCE and defined as CHIP factors. Use of a CHIP score might ...
Document Type: article in journal/newspaper
File Description: text
Language: English
Relation: https://eprints.keele.ac.uk/id/eprint/12428/1/1-s2.0-S1936879821018343-main.pdf; Protty, M, Sharp, ASP, Gallagher, S, Farooq, V, Spratt, JC, Ludman, P, Anderson, R, McEntegart, MM, Hanratty, C, Walsh, S, Curzen, N, Smith, E, Mamas, MA orcid:0000-0001-9241-8890 and Kinnaird, T (2022) Defining Percutaneous Coronary Intervention Complexity and Risk: An Analysis of the United Kingdom BCIS Database 2006-2016. JACC: Cardiovascular Interventions, 15 (1). 39 - 49.
DOI: 10.1016/j.jcin.2021.09.039
Availability: https://eprints.keele.ac.uk/id/eprint/12428/; https://eprints.keele.ac.uk/id/eprint/12428/1/1-s2.0-S1936879821018343-main.pdf; https://www.sciencedirect.com/science/article/pii/S1936879821018343?via%3Dihub; https://doi.org/10.1016/j.jcin.2021.09.039
Accession Number: edsbas.6EB0ACC6
Database: BASE