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(Circulation. 2008;117:333-335.)
© 2008 American Heart Association, Inc.

Editorial

On the Evaluation of Intervention Outcome Risks for Patients With Ischemic Heart Disease

T. Bruce Ferguson, Jr, MD

From the Department of Cardiovascular Sciences, Brody School of Medicine at ECU, Greenville, NC.

Correspondence to T. Bruce Ferguson, Jr, MD, Department of Cardiovascular Sciences, East Caroline Heart Institute, 600 Moye Blvd, TA 255, Greenville, NC 27834. E-mail fergusont@ecu.edu

Key Words: Editorials • revascularization • risk factors • outcomes research

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Risk is defined in the Oxford Pocket American Dictionary of Current English as "a chance or possibility of danger, loss, injury, etc."¹ The evaluation of clinical risk and benefit is a mainstay of all clinical investigation in medicine. More recently, it is slowly becoming a component of everyday clinical care. In this issue of Circulation, Singh et al² potentially advance the evaluation of risk in the domain of ischemic heart disease.

Article p 356

Because procedural mortality has been such an important outcome in the surgical revascularization of coronary artery disease, the assessment of preoperative risk has been an important focus of attention for many years. Large US regional and national databases, such as the Northern New England Cardiovascular Disease Study Group,³ the New York State cardiac surgery database,⁴ and the Society of Thoracic Surgeons’ National Cardiac Database (STS NCD),⁵ have developed relatively sophisticated multivariable models to predict mortality risk across the entire spectrum of coronary artery bypass grafting (CABG) patients. Similar risk models have been developed outside the United States, most notably from the European Cardiac Surgery database.⁶

Model performance has been tested and continually refined within these databases. Over the years, it has become clear that a core group of preoperative risk factors and conditions contribute a majority of the inherent mortality risk in these models. This has led to the concept that specific risk models can be applied to other CABG data sets. Nashef et al⁷ tested the performance of the EuroSCORE model against a cohort . . . [Full Text of this Article]

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