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A risk score to estimate the likelihood of coronary artery bypass surgery during the index hospitalization among patients with unstable angina and non–ST-segment elevation myocardial infarction

Saihari Sadanandan, MD^*,*, Christopher P. Cannon, MD, C. Michael Gibson, MS, MD, Sabina A. Murphy, MPH, Peter M. DiBattiste, MD, Eugene Braunwald, MD the TIMI Study Group

^* Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA
Harvard Medical School and the Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
Merck & Co., West Point, Pennsylvania, USA

View larger version (19K): [in a new window]   Figure 1 Distribution of the coronary artery bypass surgery risk score in the overall TACTICS–TIMI-18 patient population. Risk score: <3.0, 42%; 3 to 5, 55%; >5.0, 3%.

View larger version (13K): [in a new window]   Figure 2 Rates of in-hospital coronary artery bypass surgery (CABG) in patients with prior CABG and low, intermediate, and high CABG risk scores in the overall TACTICS–TIMI-18 population (n = 1,828). Association of the risk score with in-hospital CABG, p value for trend <0.0001; c-statistic 0.72.

View larger version (24K): [in a new window]   Figure 3 Association of the risk score with in-hospital coronary artery bypass surgery (CABG) in the invasive and conservative arms of TACTICS–TIMI-18 trial. Solid bars = invasive; hatched bars = conservative. Invasive arm (n = 921) p value for trend <0.0001, c-statistic 0.71; conservative arm (n = 907) p value for trend <0.0001, c-statistic 0.73.

View larger version (14K): [in a new window]   Figure 4 Validation of the coronary artery bypass surgery (CABG) risk score in Thrombolysis In Myocardial Infarction (TIMI)-11b patient population with unstable angina and non–ST-segment elevation myocardial infarction. Association of the risk score with in-hospital CABG in TIMI-11b (n = 3,722), p value for trend <0.0001; c-statistic 0.61.

View larger version (13K): [in a new window]   Figure 5 Validation of the coronary artery bypass surgery (CABG) risk score in Thrombolysis In Myocardial Infarction (TIMI)-III registry patient population with unstable angina and non–ST-segment elevation myocardial infarction. Association of the risk score with in-hospital CABG in TIMI-III registry (n = 1,139), p value for trend <0.0001; c-statistic 0.66.