Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study

Autor: Isabella Kardys, Joost Daemen, Mattie J. Lenzen, Robert-Jan van Geuns, Marco Valgimigli, K. Martijn Akkerhuis, Nick van Boven, Eric Boersma, Victor A. Umans, Ron T. van Domburg, Felix Zijlstra
Přispěvatelé: Cardiology
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Health Status
Clinical Decision-Making
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Comorbidity
Coronary Artery Disease
030204 cardiovascular system & hematology
Tertiary referral hospital
Coronary Angiography
Prosthesis Design
Risk Assessment
Decision Support Techniques
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Interquartile range
Predictive Value of Tests
Risk Factors
Internal medicine
Absorbable Implants
medicine
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Myocardial infarction
610 Medicine & health
Aged
Aged
80 and over
Proportional hazards model
business.industry
Age Factors
Percutaneous coronary intervention
Reproducibility of Results
Drug-Eluting Stents
General Medicine
Middle Aged
medicine.disease
Surgery
Clinical trial
Treatment Outcome
Conventional PCI
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and Cardiovascular Interventions, 91, 4, pp. 686-695
Catheterization and Cardiovascular Interventions, 91(4), 686-695. Wiley-Liss Inc.
Catheterization and Cardiovascular Interventions, 91, 686-695
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.27182
Popis: Item does not contain fulltext OBJECTIVES: We aimed to develop a model to predict long-term mortality after percutaneous coronary intervention (PCI), to aid in selecting patients with sufficient life expectancy to benefit from bioabsorbable scaffolds. BACKGROUND: Clinical trials are currently designed to demonstrate superiority of bioabsorbable scaffolds over metal devices up to 5 years after implantation. METHODS: From 2000 to 2011, 19.532 consecutive patients underwent PCI in a tertiary referral hospital. Patients were randomly (2:1) divided into a training (N = 13,090) and validation (N = 6,442) set. Cox regression was used to identify determinants of long-term mortality in the training set and used to develop a risk model. Model performance was studied in the training and validation dataset. RESULTS: Median age was 63 years (IQR 54-72) and 72% were men. Median follow-up was 3.6 years (interquartile range [IQR] 2.4-6.8). The ratio elective vs. non-elective PCIs was 42/58. During 88,620 patient-years of follow-up, 3,156 deaths occurred, implying an incidence rate of 35.6 per 1,000. Estimated 5-year mortality was 12.9%.Regression analysis revealed age, body mass index, diabetes mellitus, renal insufficiency, prior myocardial infarction, PCI indication, lesion location, number of diseased vessels and cardiogenic shock at presentation as determinants of mortality. The long-term risk model showed good discrimination in the training and validation sets (c-indices 0.76 and 0.74), whereas calibration was appropriate. CONCLUSIONS: A simple risk model, containing 9 baseline clinical and angiographic variables effectively predicts long-term mortality after PCI and may possibly be used to select suitable patients for bioabsorbable scaffolds.
Databáze: OpenAIRE
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