9
Table 2. Factors for Consideration by the Heart Team
Coronary Anatomy
• Left main disease
• Multivessel disease
• High anatomic complexity (i.e., bifurcation disease, high SYNTAX score)
Comorbidities
• Diabetes
• Systolic dysfunction
• Coagulopathy
• Valvular heart disease
• Frailty
• Malignant neoplasm
• End-stage renal disease
• Chronic obstructive
pulmonary disease
• Immunosuppression
• Debilitating neurological
disorders
• Liver disease/cirrhosis
• Prior CVA
• Calcified/porcelain aorta
• Aortic aneurysm
Procedural Factors
• Local and regional outcomes
• Access site for PCI
• Surgical risk
• PCI risk
Patient Factors
• Unstable presentation or shock
• Patient preferences
• Inability or unwillingness to adhere
to DAPT
• Patient social support
• Religious beliefs
• Patient education, knowledge, and
understanding
Table 3. Assessment of Risk Factors Not Quantified in the
STS Score
Risk Factor Assessment Tool
Cirrhosis MELD
Frailty Gait speed
Malnutrition MUST
Predicting Patient Risk of Death With CABG
COR LOE
Recommendation
1 B-NR 1. In patients who are being considered for CABG, calculation of
the STS risk score is recommended to help stratify patient risk.