Giá trị tiên lượng của thang điểm CADILLAC ở bệnh nhân hội chứng vành cấp không ST chênh lên được can thiệp mạch vành qua da

Abstract

This retrospective cohort study included 350 patients (median age 66 years old, 56.3% male) with non–ST-elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI); the study was performed to evaluate the prognostic value of the CADILLAC risk score for in-hospital mortality. The in-hospital mortality rate was 3.1%. Compared with survivors, non-survivors more frequently were > 65 years old, had prior myocardial infarction, atrial fibrillation, Killip class ≥ II, estimated glomerular filtration rate < 60 mL/min/1.73 m², anemia, left ventricular ejection fraction ≤ 40%, and higher CADILLAC and GRACE scores. Risk stratification using the CADILLAC score showed that 81.8% of deaths occurred in the high-risk group, while no death observed in the low-risk group. The CADILLAC score exhibited reasonably good discriminatory ability for in-hospital mortality (AUC = 0.890; 95% CI: 0.852 – 0.921); at a cutoff > 11, sensitivity was 77.8%, specificity 95.0%, positive predictive value 29.2%, and negative predictive value 98.8%. In multivariable logistic regression analysis, the CADILLAC score was independently associated with in-hospital mortality. Within the context of a single-center study with a moderate sample size and a low number of in-hospital death events, these findings suggest that the CADILLAC score has potential to be a useful adjunct tool for early in-hospital risk stratification in NSTE-ACS patients undergoing PCI.