Risk assessment to predict arterial and venous events in patients undergoing percutaneous coronary intervention

Area of Science:

• Cardiovascular Medicine
• Thrombosis Research

Background:

• Atherosclerosis and venous thromboembolism (VTE) share common risk factors, indicating potential overlapping pathophysiological mechanisms.
• Patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) are a relevant population to study these associations.

Purpose of the Study:

• To assess the strength of association between atherosclerosis risk factors and VTE in patients with CAD undergoing PCI.
• To compare the predictive performance of risk scores for major adverse cardiac and cerebrovascular events (MACCEs) and VTE.

Main Methods:

• Pooled data from 6 global randomized controlled trials on coronary stenting (ENDEAVOR and SIRIUS programs).
• Developed separate risk scores for MACCEs (cardiac death, myocardial infarction, stroke) and VTE.
• Compared the predictive performance of these risk scores using the area under the receiver-operating characteristic curve (AUC).

Main Results:

• The 5-year incidence rates were 10.8% for MACCEs and 2.04% for VTE.
• Predictors for MACCEs showed similar performance in predicting VTE (AUC 0.651 vs 0.672).
• Predictors for VTE demonstrated comparable performance in predicting MACCEs (AUC 0.699 vs 0.620).
• Ejection fraction and age were identified as significant predictors for both MACCEs and VTE.

Conclusions:

• Findings support the concept of overlapping pathophysiology between VTE and atherothrombosis.
• Risk factors and predictors for atherosclerosis-related events and VTE are not entirely distinct.
• Further research into shared mechanisms could inform integrated prevention strategies for these cardiovascular conditions.