Major adverse cardiovascular event
Major adverse cardiovascular event (MACE) refers to a combined or composite clinical endpoint that is used for outcome evaluations in clinical trials for cardiovascular research intended as a measure of safety and effectiveness and does not have a specific definition.
In the setting relevant for percutaneous coronary interventions (PCI) a major adverse cardiovascular event (MACE) has been defined relating to the safety and effectiveness of as one of the following 1,2:
- cardiovascular death
- myocardial infarction
- stent thrombosis
- repeat revascularisation including bypass graft
Since there is no standard definition of other adverse cardiovascular outcomes as e.g. stroke, heart failure recurrent angina 1,2.
History and etymology
The term MACE seems to have originated in the 1990s and was related primarily to percutaneous coronary interventions 1-3.
- 1. Kip KE, Hollabaugh K, Marroquin OC, Williams DO. The problem with composite end points in cardiovascular studies: the story of major adverse cardiac events and percutaneous coronary intervention. (2008) Journal of the American College of Cardiology. 51 (7): 701-7. doi:10.1016/j.jacc.2007.10.034 - Pubmed
- 2. Poudel I, Tejpal C, Rashid H, Jahan N. Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review. (2019) Cureus. 11 (7): e5280. doi:10.7759/cureus.5280 - Pubmed
- 3. Hermans WR, Foley DP, Rensing BJ, Rutsch W, Heyndrickx GR, Danchin N, Mast G, Hanet C, Lablanche JM, Rafflenbeul W. Usefulness of quantitative and qualitative angiographic lesion morphology, and clinical characteristics in predicting major adverse cardiac events during and after native coronary balloon angioplasty. CARPORT and MERCATOR Study Groups. (1993) The American journal of cardiology. 72 (1): 14-20. doi:10.1016/0002-9149(93)90211-t - Pubmed