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Title: | Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score | Authors: | Chichareon, Ply van Klaveren, David Modolo, Rodrigo Kogame, Norihiro Takahashi, Kuniaki Chang, Chun-Chin Tomaniak, Mariusz Yuan, Jinqing Xie, Lihua Song, Ying Qiao, Shubin Yang, Yuejin Guan, Changdong Zurakowski, Aleksander van Geuns, Robert-Jan Sabate, Manel Ong, Paul J. Wykrzykowska, Joanna J. Piek, Jan J. Garg, Scot Hamm, Christian Steg, Gabriel VRANCKX, Pascal Valgimigli, Marco Windecker, Stephan Juni, Peter Onuma, Yoshinobu Steyerberg, Ewout Xu, Bo Serruys, Patrick W. |
Issue Date: | 2021 | Publisher: | WILEY | Source: | CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 98 (7) , p. 1287-1297 | Abstract: | Aims We aimed to update the logistic clinical SYNTAX score to predict 2 year all-cause mortality after contemporary percutaneous coronary intervention (PCI). Methods and results We analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The logistic clinical SYNTAX model was updated after imputing missing values by refitting the original model (refitted original model) and fitting an extended new model (new model, with, selection based on the Akaike Information Criterion). External validation was performed in 10,100 patients having PCI at Fu Wai hospital. Chronic obstructive pulmonary disease, prior stroke, current smoker, hemoglobin level, and white blood cell count were identified as additional independent predictors of 2 year all-cause mortality and included into the new model. The c-indexes of the original, refitted original and the new model in the derivation cohort were 0.74 (95% CI 0.72-0.76), 0.75 (95% CI 0.73-0.77), and 0.78 (95% CI 0.76-0.80), respectively. The c-index of the new model was lower in the validation cohort than in the derivation cohort, but still showed improved discriminative ability of the newly developed model (0.72; 95% CI 0.67-0.77) compared to the refitted original model (0.69; 95% CI 0.64-0.74). The models overestimated the observed 2 year all-cause mortality of 1.11% in the Chinese external validation cohort by 0.54 percentage points, indicating the need for calibration of the model to the Chinese patient population. Conclusions The new model of the logistic clinical SYNTAX score better predicts 2 year all-cause mortality after PCI than the original model. The new model could guide clinical decision making by risk stratifying patients undergoing PCI. | Other: | Xu, B (corresponding author), Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fu Wai Hosp, Natl Clin Res Ctr Cardiovasc Dis, Beijing, Peoples R China ; Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, A 167,Beilishi Rd, Beijing 100037, Peoples R China. Serruys, PW (corresponding author), Natl Univ Ireland Galway, Dept Cardiol, Galway, Ireland ; Imperial Coll London, NHLI, London, England ; Natl Univ Ireland Galway NUIG, Cardiol, Univ Rd, Galway H91 TK33, Ireland. bxu@citmd.com; patrick.w.j.c.serruys@pwserruys.com | Keywords: | coronary artery disease;percutaneous coronary intervention;risk score;risk stratification | Document URI: | http://hdl.handle.net/1942/33867 | ISSN: | 1522-1946 | e-ISSN: | 1522-726X | DOI: | 10.1002/ccd.29490 | ISI #: | 000614528500001 | Rights: | 2021 Wiley Periodicals LLC. Free access | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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Predicting 2‐year all‐cause mortality after contemporary PCI_ Updating the logistic clinical SYNTAX score.pdf | Published version | 2.27 MB | Adobe PDF | View/Open |
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