RT Journal Article SR Electronic T1 Comorbid conditions and outcomes after percutaneous coronary intervention JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1424 OP 1428 DO 10.1136/hrt.2007.126649 VO 94 IS 11 A1 M Singh A1 C S Rihal A1 V L Roger A1 R J Lennon A1 J Spertus A1 A Jahangir A1 D R Holmes, Jr YR 2008 UL http://heart.bmj.com/content/94/11/1424.abstract AB Objective: To evaluate whether adding comorbid conditions to a risk model can help predict in-hospital outcome and long-term mortality after percutaneous coronary intervention (PCI).Design: Retrospective chart reviewSetting: Academic medical centre.Patients: 7659 patients who had 9032 PCIs.Interventions: PCI performed at Mayo Clinic between 1 January 1999 and 30 June 2004.Main outcome measures: The Mayo Clinic Risk Score (MCRS) and the coronary artery disease (CAD)-specific index for determination of comorbid conditions in all patients.Results: The mean (SD) MCRS score was 6.5 (2.9). The CAD-specific index was 0 or 1 in 46%, 2 or 3 in 30% and 4 or higher in 24%. The rate of in-hospital major adverse cardiovascular events (MACE) increased with higher MCRS and CAD-specific index (Cochran–Armitage test, p<0.001 for both models). The c-statistic for the MCRS for in-hospital MACE was 0.78; adding the CAD-specific index did not improve its discriminatory ability for in-hospital MACE (c-statistic = 0.78; likelihood ratio test, p = 0.29). A total of 707 deaths after dismissal occurred after 7253 successful procedures. The c-statistic for all-cause mortality was 0.69 for the MCRS model alone and 0.75 for the MCRS and CAD-specific indices together (likelihood ratio test, p<0.001), indicating significant improvement in the discriminatory ability.Conclusions: Addition of comorbid conditions to the MCRS adds significant prognostic information for post-dismissal mortality but adds little prognostic information about in-hospital complications after PCI. Such health-status measures should be included in future risk stratification models that predict long-term mortality after PCI.