Risk stratification and prediction in patients with coronary artery disease undergoing contemporary revascularization

Myocardial revascularization is a mainstay for the treatment of acute coronary syndrome and has been proved to enhance the survival of the patients. In chronic coronary syndrome, myocardial revascularization plays a role as adjunctive therapy to optimal medical therapy. Not every coronary artery disease patient is the same. Patients can be different in terms of clinical characteristics, disease complexity, personal perception of the disease, and preference for the treatment. Many of these factors contribute to the outcomes of the patients after revascularization. Personalized care by taking all relevant factors into account is the ultimate goal of the current practice.
Risk stratification and risk score contribute to the prediction of the occurrence of adverse events and help in selecting patients with high risk for the interesting events and ultimately aim at delivering tailor-made treatment to the individual patient. The characteristics of the patients presenting with coronary artery disease are changing as a consequence of the increased lifespan of the population, and the treatment has been evolving. These aspects may alter the prognosis of the patients and may affect the performance of the risk stratification or predictive models. Therefore, the impact of clinical and procedural characteristics and treatment on patients’ outcomes should be reassessed in contemporary practice.
Risk stratification and prediction are not static but need to be dynamic to avoid being declared obsolete or outdated. In this thesis, we provide an insight to the risk stratification and prediction of coronary artery disease patients undergoing revascularization in contemporary practice.