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Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score.
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.
Afiliação
  • Chichareon P; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • van Klaveren D; Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
  • Modolo R; Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Kogame N; Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
  • Takahashi K; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Chang CC; Department of Internal Medicine, Cardiology Division, University of Campinas (UNICAMP), Campinas, Brazil.
  • Tomaniak M; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Yuan J; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Xie L; Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Song Y; Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Qiao S; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
  • Yang Y; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • Guan C; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • Zurakowski A; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • van Geuns RJ; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • Sabate M; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • Ong PJ; National Clinical Research Center for Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China.
  • Wykrzykowska JJ; American Heart of Poland, Center for Cardiovascular Research and Development, Katowice, Poland.
  • Piek JJ; Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Garg S; University Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  • Hamm C; Tan Tock Seng Hospital, Novena, Singapore.
  • Steg G; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Vranckx P; Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Valgimigli M; East Lancashire Hospitals NHS Trust, Blackburn, UK.
  • Windecker S; Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany.
  • Juni P; FACT, French Alliance for Cardiovascular Trials; Hôpital Bichat, AP-HP, Université Paris-Diderot; and INSERM U-1148, all in Paris, Paris, France.
  • Onuma Y; Royal Brompton Hospital, Imperial College, London, UK.
  • Steyerberg E; Hartcentrum Hasselt, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
  • Xu B; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
  • Serruys PW; Department of Cardiology, Bern University Hospital, Bern, Switzerland.
Catheter Cardiovasc Interv ; 98(7): 1287-1297, 2021 12 01.
Article em En | MEDLINE | ID: mdl-33539048
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Intervenção Coronária Percutânea Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença da Artéria Coronariana / Intervenção Coronária Percutânea Idioma: En Ano de publicação: 2021 Tipo de documento: Article