Gensini score values for predicting periprocedural myocardial infarction: An observational study analysis

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomarkers

Background:

• The Gensini score (GS) is established for assessing coronary artery disease severity.
• Periprocedural myocardial infarction (PMI) is a significant complication following coronary revascularization.
• Understanding predictors of PMI is crucial for patient management.

Purpose of the Study:

• To investigate the relationship between the Gensini score (GS) and periprocedural myocardial infarction (PMI).
• To determine if GS is an independent predictor of PMI after single coronary artery revascularization.
• To identify optimal GS cut-off values for predicting different thresholds of PMI.

Main Methods:

• Retrospective analysis of 4949 patients undergoing single coronary artery revascularization.
• Patients categorized into Low, Intermediate, and High Gensini score groups (tertiles).
• Periprocedural myocardial infarction defined by cardiac troponin I (cTnI) levels (PMI3 and PMI5).
• Statistical analysis including logistic regression and receiver operating characteristic (ROC) curve analysis.

Main Results:

• The incidence of PMI was significantly higher in the High GS group compared to the Intermediate, and in the Intermediate compared to the Low group.
• Gensini score was an independent predictor for both PMI3 (β = 0.006, P < .05) and PMI5 (β = 0.007, P < .05) after adjusting for covariates.
• Optimal cut-off values for predicting PMI were identified as 22.5 for PMI3 and 27 for PMI5 via ROC analysis.

Conclusions:

• The Gensini score is an independent predictor of periprocedural myocardial infarction in patients undergoing single coronary artery revascularization.
• Specific Gensini score thresholds (22.5 for PMI3, 27 for PMI5) can aid in predicting PMI risk.
• These findings support the utility of the Gensini score in risk stratification for coronary revascularization procedures.