Risk Stratification and Interventional Cardiology: Robert L Risk Stratification and Interventional Cardiology: Robert L. Frye Lecture  David R. Holmes, MD  Mayo Clinic Proceedings  Volume 78, Issue 12, Pages 1507-1518 (December 2003) DOI: 10.4065/78.12.1507 Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Change in frequency of emergency coronary artery bypass graft (CABG) surgery after percutaneous coronary intervention (n=18,593). With the introduction of coronary stents (which came into general use in the mid 1990s), the rates of emergency CABG surgery decreased significantly (P<.001). Mayo Clinic Proceedings 2003 78, 1507-1518DOI: (10.4065/78.12.1507) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 In-hospital mortality by risk decile observed in the National Heart, Lung, and Blood Institute Dynamic Registry and predicted by using the New York State, Northern New England, Cleveland Clinic, American College of Cardiology (ACC), and University of Michigan models. From Holmes et al,66 with permission from the American Heart Association. Mayo Clinic Proceedings 2003 78, 1507-1518DOI: (10.4065/78.12.1507) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Left, Estimated rates of procedural complications with the integer scoring system. The integers are proportional to the estimated continuous coefficient from the logistic model. Percentages of patients at risk are shown for each of the 5 risk categories: =2% is very low risk for complications with coronary angioplasty; >2% to 5%, low risk; >5% to 10%, moderate risk; >10% to 25%, high risk; and >25%, very high risk. NYHA = New York Heart Association. Right, The observed and corresponding predicted procedural complications in the validation-set with the proposed risk score. The x-axis represents the risk score in the validation-set. The y-axis represents the complication rate. The solid line shows the predicted procedural complications derived from the risk score. The bars represent observed procedural complications in the validation-set. Three patients had a score >19; all 3 were free of complications. From Singh et al,65 with permission from the American College of Cardiology. Mayo Clinic Proceedings 2003 78, 1507-1518DOI: (10.4065/78.12.1507) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions