Evaluation of long-term adverse cardiovascular events risk after elective percutaneous coronary intervention

The aim of our study was to analyze long-term outcomes, to identify their predictors and to develop a model for determining the risk of long-term adverse сardiovascular events after elective percutaneous coronary interventions (PCI). A retrospective study included 151 patients 6 years after the elective PCI. Outcomes were assessed by analyzing medical records and telephone interviews. The primary composite end point of the study was a major adverse cardiovascular event (MACCE), including death from cardiovascular causes, acute coronary syndrome, acute cerebrovascular accident. Death from cardiovascular events was reported in 10.6 % of patients, acute coronary syndrome occurred in 34.4 %, stroke - in 6.6 %. Thus MAСCE occurred in 40.4 % of patients. MACCE predictors in the long-term period were chronic kidney disease, contrast-induced acute kidney injury, baseline C-reactive protein more than 5.5 mg/l. Restenosis of previously installed stents increases the risk of MACCE at 8.09 times, chronic obstructive pulmonary disease - 3.4 times PT - 2.84 times, family history for cardiovascular disease (CVD) - in 2.94 times, a very high risk of contrast-induced nephropathy (CIN) (≥11 points on the R. Mehran scale) - 2.15 times. The most significant MACCE's predictors identified using stepwise logistic regression and included in the developed model are: family history for СVD, statins reception during the procedure of PCI, the initial level of postprandial blood glucose, high risk of CIN (11-15 points on a scale of R. Mehran). AUC values for the found model was 0.852 [95 % CI 0.749-0.956]. The use of our model of risk stratification in patients after elective PCI allows, on the basis of simple clinical characteristics, to distinguish groups of patients with a high residual risk of adverse cardiovascular events that require the timely application of more active follow-up strategies.