Predictive value of the thrombotic risk criteria proposed in the 2023 European Society of Cardiology (ESC) guidelines for the management of acute coronary syndrome (ACS): insights from a large percutaneous coronary intervention (PCI) registry
Authors' conclusion
The thrombotic risk criteria of the 2023 ESC guidelines for ACS enable to stratify patients undergoing PCI in categories with an incremental 1 year risk of MACE; however, their overall predictive ability for MACE is modest.
Study context
- Population
- Consecutive patients with acute or chronic coronary syndrome undergoing PCI at a large tertiary-care centre, 2014–2019
- Participants
- 11,787 patients
- Exposure
- Moderate or high vs low thrombotic risk
- Low riskn = 2,641reference
- Moderate riskn = 5,286
- High riskn = 3,860
- Outcome
- MACE:
- All-cause death
- MI
- Stroke
- Follow-up
- 1 year
Methodological detailssingle-centre, registry
- Single-centre
- Registry
Main finding
As reported in the abstract
Each group vs low riskHazard ratio (95% CI)
Moderate risk
2.53(1.78–3.58)
High risk
3.39(2.39–4.80)
- Harrell's C-index for MACE
- 0.60
Observational data: associations, not effects.
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Major bleedingHigh riskvs Low risk | 1.59 (1.25–2.02) | |
| 0.512Hazard ratio (log scale) |
Major bleeding
- Similar between moderate and low risk
Original publication
Predictive value of the thrombotic risk criteria proposed in the 2023 ESC guidelines for the management of ACS: insights from a large PCI registry. Eur Heart J Cardiovasc Pharmacother. Published 23 September 2023. doi:10.
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