PMID- 34772341
OWN - NLM
STAT- MEDLINE
DCOM- 20220128
LR  - 20220128
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Nov 12
TI  - The CADILLAC risk score accurately identifies patients at low risk for 
      in-hospital mortality and adverse cardiovascular events following ST elevation 
      myocardial infarction.
PG  - 533
LID - 10.1186/s12872-021-02348-0 [doi]
LID - 533
AB  - BACKGROUND: The CADILLAC risk score was developed to identify patients at low 
      risk for adverse cardiovascular events following ST elevation myocardial 
      infarction (STEMI) treated with primary percutaneous coronary intervention 
      (PPCI). METHODS: We performed a single center retrospective review of STEMI 
      hospitalizations treated with PPCI from 2014 to 2018. Patients were stratified 
      using the CADILLAC risk score into low risk, intermediate risk and high risk 
      groups. Patients presenting with cardiac arrest or cardiogenic shock were 
      excluded from the study. The primary outcome was adverse clinical events during 
      initial hospitalization. Secondary outcomes were adverse clinical events at 
      30 days and 1 year following index hospitalization. RESULTS: The study included 
      341 patients. Compared to patients with a low CADILLAC score, adverse clinical 
      events were similar in the intermediate risk group during hospitalization (OR 
      1.23, CI 0.37-4.05, p 0.733) and at 30 days (OR 2.27, CI 0.93-5.56, p 0.0733) 
      while adverse clinical events were significantly elevated in the high risk group 
      during hospitalization (OR 4.75, CI 1.91-11.84, p 0.0008) and at 30 days (OR 
      8.73, CI 4.02-18.96, p < 0.0001). At 1 year follow-up, compared to the low risk 
      CADILLAC group (9.4% adverse clinical event rate), cumulative adverse clinical 
      events were significantly higher in the intermediate risk group (22.9% event 
      rate, OR 2.86, CI 1.39-5.89, p 0.0044) and in the elevated risk group (58.6% 
      event rate, OR 13.67, CI 6.81-27.43, p < 0.0001). The mortality rate was 0% for 
      patients defined at low risk by CADILLAC score during hospitalization, as well up 
      to 1 year follow up. On receiver operating curve analysis, discrimination of 
      in-hospital adverse clinical events was fair using CADILLAC (C = 0.66, odds ratio 
      1.18; 95% CI 1.04-1.33; p = 0.0064) with somewhat better discrimination at 30-day 
      follow-up (C = 0.719) and 1-year follow-up (C = 0.715). CONCLUSION: Patients 
      defined as low risk by the CADILLAC score following a STEMI were associated with 
      lower mortality and adverse clinical event rates during hospitalization and up to 
      1 year following STEMI when compared to those with an intermediate or high 
      CADILLAC score.
CI  - (c) 2021. The Author(s).
FAU - Wilson, Ryan S
AU  - Wilson RS
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA. 
      rwilson6@pennstatehealth.psu.edu.
FAU - Malamas, Peter
AU  - Malamas P
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA.
FAU - Dembo, Brent
AU  - Dembo B
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA.
FAU - Lall, Sumeet K
AU  - Lall SK
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA.
FAU - Zaman, Ninad
AU  - Zaman N
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA.
FAU - Peterson, Brandon R
AU  - Peterson BR
AD  - Department of Medicine, Penn State College of Medicine, Penn State Milton S. 
      Hershey Medical Center, 500 University Drive, Box H047, Hershey, PA, 17033, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20211112
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Aged
MH  - Cardiovascular Diseases/etiology
MH  - Female
MH  - *Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention
MH  - Retrospective Studies
MH  - *Risk Assessment
MH  - *Risk Factors
MH  - ST Elevation Myocardial Infarction/*complications/mortality/therapy
MH  - Severity of Illness Index
PMC - PMC8588705
OTO - NOTNLM
OT  - Coronary artery disease
OT  - Risk stratification
OT  - ST segment elevation myocardial infarction
COIS- The authors declare that they have no competing interests.
EDAT- 2021/11/14 06:00
MHDA- 2022/01/29 06:00
PMCR- 2021/11/12
CRDT- 2021/11/13 05:24
PHST- 2021/05/30 00:00 [received]
PHST- 2021/10/25 00:00 [accepted]
PHST- 2021/11/13 05:24 [entrez]
PHST- 2021/11/14 06:00 [pubmed]
PHST- 2022/01/29 06:00 [medline]
PHST- 2021/11/12 00:00 [pmc-release]
AID - 10.1186/s12872-021-02348-0 [pii]
AID - 2348 [pii]
AID - 10.1186/s12872-021-02348-0 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2021 Nov 12;21(1):533. doi: 10.1186/s12872-021-02348-0.