{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:52:18Z","timestamp":1788187938412,"version":"build-2803163510"},"reference-count":15,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Patient outcomes after percutaneous coronary intervention (PCI) have improved over the last 30 years due to better techniques, therapies, and care processes. This study evaluated contemporary predictors of post-PCI major adverse cardiovascular events (MACE) and summarized risk in a parsimonious risk prediction model. Methods: The Cardiovascular Patient-Level Analytical Platform (CLiPPeR) is an observational dataset of baseline variables and longitudinal outcomes from the American College of Cardiology\u2019s CathPCI Registry\u00ae and national claims data. Cox regression was used to evaluate 2\u20136 years of patient follow-up (mean: 2.56 years), ending in December 2017, after index PCI between 2012 and 2015 (N = 1,450,787), to examine clinical and procedural predictors of MACE (first myocardial infarction, stroke, repeat PCI, coronary artery bypass grafting, and mortality). Cox analyses of post-PCI MACE were landmarked 28 days after index PCI. Results: Overall, 12.4% (n = 179,849) experienced MACE. All variables predicted MACE, with cardiogenic shock, cardiac arrest, four diseased coronary vessels, and chronic kidney disease having hazard ratios (HRs) \u2265 1.50. Other major predictors of MACE were in-hospital stroke, three-vessel disease, anemia, heart failure, and STEMI presentation. The index revascularization and discharge prescription of aspirin, P2Y12 inhibitor, and lipid-lowering medication had HR \u2264 0.67. The primary Cox model had c-statistic c = 0.761 for MACE versus c = 0.701 for the parsimonious model and c = 0.752 for the parsimonious model plus treatment variables. Conclusions: In a nationally representative US sample of post-PCI patients, predictors of longitudinal MACE risk were identified, and a parsimonious model efficiently encapsulated them. These findings may aid in assessing care processes to further improve care post-PCI outcomes.<\/jats:p>","DOI":"10.3390\/jcm13102844","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T09:28:25Z","timestamp":1715592505000},"page":"2844","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Contemporary Predictors of Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention: A Nationally Representative US Sample"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2656-0263","authenticated-orcid":false,"given":"Benjamin D.","family":"Horne","sequence":"first","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA"},{"name":"Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA"},{"name":"Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipun","family":"Atreja","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Venditto","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5282-4023","authenticated-orcid":false,"given":"Thomas","family":"Wilson","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Muhlestein","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA"},{"name":"Cardiology Division, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua R.","family":"St. Clair","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3544-4130","authenticated-orcid":false,"given":"Kirk U.","family":"Knowlton","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA"},{"name":"Cardiology Division, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naeem D.","family":"Khan","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narinder","family":"Bhalla","sequence":"additional","affiliation":[{"name":"AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA"},{"name":"Cardiology Division, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1016\/j.jacc.2018.11.002","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol: Executive summary: A report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Grundy","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1001\/jama.2016.3775","article-title":"Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention","volume":"315","author":"Yeh","year":"2016","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e000723","DOI":"10.1136\/openhrt-2017-000723","article-title":"Clinically feasible stratification of 1- to 3-year post-myocardial infarction risk","volume":"5","author":"Horne","year":"2018","journal-title":"Open Heart"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ahj.2019.09.004","article-title":"Risk score-guided multidisciplinary team-based care for heart failure inpatients is associated with lower 30-day readmission and lower 30-day mortality","volume":"219","author":"Horne","year":"2020","journal-title":"Am. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1016\/S0735-1097(01)01702-8","article-title":"American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes. A report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee)","volume":"38","author":"Cannon","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1016\/j.jacc.2012.08.966","article-title":"A contemporary view of diagnostic cardiac catheterization and percutaneous coronary intervention in the United States. A report from the CathPCI Registry of the National Cardiovascular Data Registry, 2010 Through June 2011","volume":"60","author":"Dehmer","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.jacc.2018.06.023","article-title":"External validation of the DAPT Score in a nationwide population","volume":"72","author":"Ueda","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","first-page":"459","article-title":"The American College of Cardiology national database: Progress and challenges","volume":"29","author":"Weintraub","year":"1997","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/S0735-1097(01)01372-9","article-title":"The American College of Cardiology\u2014National Cardiovascular Data Registry (ACC-NCDR): Building a national clinical data repository","volume":"37","author":"Brindis","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"II27","DOI":"10.1136\/hrt.82.2008.ii27","article-title":"Long term outcome after coronary stent implantation: A 10 year single centre experience of 1000 patients","volume":"82","author":"Foley","year":"1999","journal-title":"Heart"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1001\/jamacardio.2017.0063","article-title":"Mortality following cardiovascular and bleeding events occurring beyond 1 year after coronary stenting. A secondary analysis of the Dual Antiplatelet Therapy (DAPT) Study","volume":"2","author":"Secemsky","year":"2017","journal-title":"JAMA Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jcin.2013.03.020","article-title":"Enhanced mortality risk prediction with a focus on high-risk percutaneous coronary intervention. Results from 1,208,137 procedures in the NCDR (National Cardiovascular Data Registry)","volume":"6","author":"Brennan","year":"2013","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.carrev.2022.01.029","article-title":"Predictors of in-hospital de-escalation of P2Y12 inhibitors to clopidogrel in patients with acute myocardial infarction treated with percutaneous coronary intervention","volume":"42","author":"Williams","year":"2022","journal-title":"Cardiovasc. Revasc Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1016\/j.jacc.2017.09.011","article-title":"Lesion complexity and outcomes of extended dual antiplatelet therapy after percutaneous coronary intervention","volume":"70","author":"Yeh","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1056\/NEJMoa1410489","article-title":"Ezetimibe added to statin therapy after acute coronary syndromes","volume":"372","author":"Cannon","year":"2015","journal-title":"N. Engl. J. 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