Impact of the Charlson Comorbidity Index on the Short-Term and Long-Term Prognoses of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Yixin Ma, Hongyu Luo, Huan Zhao, Ou Zhao, Lina Ma, Wei Yang, Ming Yi, Lijie Sun, Jing Li Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People’s Republic of ChinaCorrespondence: Jing Li, Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People’s Republic of China, Email shpxbb@sina.comBackground: The Charlson Comorbidity Index (CCI) is widely used to assess comorbidity burden, its prognostic role in patients undergoing percutaneous coronary intervention (PCI) remains underexplored. This study aimed to investigate the impact of CCI on in-hospital adverse events and long-term major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with coronary artery disease (CAD) treated with PCI.Methods: A total of 572 consecutive CAD patients who underwent PCI between October 2016 and October 2020 were included. Patients were divided into low (CCI ≤ 4, n = 453) and high (CCI > 4, n = 119) comorbidity burden groups. Clinical characteristics, in-hospital adverse events, and long-term MACCEs were compared. Multivariate logistic regression and Cox proportional hazards models were used to identify independent predictors of outcomes.Results: Compared to the low-CCI group, patients in the high-CCI group were older, more frequently male, and had higher rates of diabetes, left main CAD, and multivessel disease (all p < 0.05). In-hospital adverse events were significantly more common in the high-CCI group (13.4% vs 2.0%, p < 0.01). CCI was an independent predictor of in-hospital events (OR = 3.13; 95% CI: 1.40– 7.02). During a median follow-up of five years, the high-CCI group had a significantly higher incidence of MACCEs (51.3% vs 6.2%; HR = 2.72; 95% CI: 2.25– 3.30, p < 0.01).Conclusion: CCI is a significant and independent predictor of both in-hospital and long-term adverse outcomes in CAD patients undergoing PCI.Keywords: Charlson comorbidity index, coronary artery disease, percutaneous coronary intervention, in-hospital adverse events, major adverse cardiovascular and cerebrovascular events, prognostic evaluation