BCIS myocardial jeopardy score predicts post-PCI death

Kalpa De Silva, M.B.B.S., of King's College London, and colleagues conducted a retrospective study involving 660 patients who underwent PCI with previous left ventricular function assessment. Of these, 221 patients had previously undergone coronary artery bypass grafting (CABG). Blinded observers calculated the BCIS-JS before (BCIS-JS_PRE) and after (BCIS-JS_POST) PCI, and the extent of revascularization was quantified using the revascularization index (RI; RI = [BCIS-JS_PRE − BCIS-JS_POST]/BCIS-JS_PRE).

The researchers found that both BCIS-JS_PRE and BCISJS_POST scores were directly related to all-cause mortality (hazard ratios [HRs], 2.96 and 4.02, respectively). Other independent predictors of mortality included having a RI of less than 0.67 (HR, 1.99), left ventricular dysfunction (HR, 2.03), and renal impairment (HR, 3.75), in multivariate analysis.

"The present findings have demonstrated that the BCIS-JS has prognostic significance in a contemporary cohort of patients undergoing PCI. Higher BCIS-JS_PRE and BCIS-JS_POST scores are associated with increased mortality and the BCIS-JS-derived RI is an independent predictor of mortality," the authors write. "Our findings confirm that the BCIS-JS is a highly reproducible, valid angiographic scoring tool and supports its use in risk stratification and guiding PCI in patients with coronary artery disease, including patients who have undergone previous CABG."

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Journal reference: American Journal of Cardiology

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