The Prognostic Value of Residual Gensini Score on 1-Year Cardiac Mortality in Patients Undergoing Percutaneous Coronary Intervention

Mohammad Reza  Ahi; Abbas  Andishmand; Mahdieh  Namayandeh; Farzaneh  Firouzi

doi:10.18502/jthc.v20i4.20745

Mohammad Reza Ahi Clinical Research Development Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abbas Andishmand Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Mahdieh Namayandeh Clinical Research Development Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Farzaneh Firouzi Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/jthc.v20i4.20745

Keywords: Percutaneous Coronary Intervention; Residual Gensini Score; Cardiac Mortality; Prognosis; Coronary Artery Disease; Comorbidities

Abstract

Background: Percutaneous coronary intervention (PCI) is a cornerstone in the management of obstructive coronary artery disease. The Gensini score quantitatively assesses the severity and complexity of coronary lesions. The residual Gensini score (rGensini), measured after PCI, may offer superior prognostic information compared with the baseline score. This study aimed to investigate the association between rGensini and cardiac mortality.

Methods: In this study, all consecutive patients who registered for follow-up at the Afshar Hospital Health Promotion Center within 30 days after PCI were included. The primary outcome was cardiac mortality. Baseline characteristics, comorbidities (diabetes, hypertension, dyslipidemia, and prior cardiac history), smoking status, family history, coronary dominance pattern, and coronary calcification were recorded. Patients were stratified into four risk categories based on rGensini: zero-risk (0), low-risk (>0 to ≤11), moderate-risk (>11 to ≤37), and high-risk (>37). Survival analysis was performed using the Kaplan-Meier method, and independent predictors of cardiac mortality were identified using Cox proportional hazards regression.

Results: The study included 141 patients (85 men and 56 women) with a mean age of 60.67 years. The mean Gensini score decreased from 31.22 at baseline to 18.20 after PCI. Over a median follow-up time of 9 months, 10 cardiac deaths occurred. Kaplan-Meier curves demonstrated a significant gradation in survival probability across the strata. Multivariable Cox regression analysis identified rGensini category, age, coronary calcification, diabetes, and hypertension as independent predictors of cardiac mortality.

Conclusion: This hypothesis-generating study suggests that the rGensini score is a promising and independent predictor of cardiac mortality after PCI.