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Wall JJS, Iqbal J, Andrews M, et al. Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention. Open Heart. 2017;4(2):e000576doi: 10.1136/openhrt-2016-000576.
Wall, J. J. S., Iqbal, J., Andrews, M., Teare, D., Ghobrial, M., Hinton, T., Turton, S., Quffa, L., El-Omar, M., Fraser, D. G., Siotia, A., & Gunn, J. (2017). Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention. Open heart, 4(2), e000576. https://doi.org/10.1136/openhrt-2016-000576
Wall, Joshua J S, et al. "Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention." Open heart vol. 4,2 (2017): e000576. doi: https://doi.org/10.1136/openhrt-2016-000576
Wall JJS, Iqbal J, Andrews M, Teare D, Ghobrial M, Hinton T, Turton S, Quffa L, El-Omar M, Fraser DG, Siotia A, Gunn J. Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention. Open Heart. 2017 Jul 25;4(2):e000576. doi: 10.1136/openhrt-2016-000576. eCollection 2017. PMID: 28878944; PMCID: PMC5574428.
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Open Heart. 2017 Jul 25;4(2):e000576. doi: 10.1136/openhrt-2016-000576. eCollection 2017.

Development and validation of a clinical risk score to predict mortality after percutaneous coronary intervention.

Open heart

Joshua J S Wall, Javaid Iqbal, Michael Andrews, Dawn Teare, Mina Ghobrial, Thomas Hinton, Samuel Turton, Leila Quffa, Magdi El-Omar, Douglas G Fraser, Anjan Siotia, Julian Gunn

Affiliations

  1. Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
  2. South Yorkshire Cardiothoracic Centre, Sheffield, UK.
  3. Sheffield School for Health and Related Research, Sheffield, UK.
  4. Freeman Hospital, Newcastle Upon Tyne Hospitals Foundation Trust, Newcastle Upon Tyne, UK.
  5. Bristol Heart Institute, Bristol, UK.
  6. University of Bristol, Bristol, UK.
  7. Faculty of Medicine, Imperial College London, London, UK.
  8. Manchester Royal Infirmary, Manchester, UK.
  9. BM Birla Heart Research Centre, Kolkata, India.
  10. Insigneo Institute for In Silico Medicine, Sheffield, UK.

PMID: 28878944 PMCID: PMC5574428 DOI: 10.1136/openhrt-2016-000576

Abstract

OBJECTIVE: To develop and validate a contemporary clinical risk score to predict mortality after percutaneous coronary intervention (PCI).

METHODS: Using data collected from patients undergoing PCI at the South Yorkshire Cardiothoracic Centre, Sheffield, UK, between January 2007 and September 2013, a risk score was developed to predict mortality. Logistic regression was used to evaluate the effect of each variable upon 30-day mortality. A backwards stepwise logistic regression model was then used to build a predictive model. The results were validated both internally and externally with data from Manchester Royal Infirmary, UK. 30-Day mortality status was determined from the UK Office of National Statistics.

RESULTS: The development data set comprised 6522 patients from Sheffield. Five risk factors, including cardiogenic shock, procedural urgency, history of renal disease, diabetes mellitus and age, were statistically significant to predict 30-day mortality. The risk score was validated internally on a further 3290 patients from Sheffield and externally on 3230 patients from Manchester. The discrimination of the model was high in the development (C-statistic=0.82, 95% CI 0.79 to 0.85), internal (C-statistic=0.81, 95% CI 0.76 to 0.86) and external (C statistics=0.90, 95% CI 0.87 to 0.93) cohorts. There was no significant difference between observed and predicted mortality in any group.

CONCLUSION: This contemporary risk score reliably predicts 30-day mortality after PCI using a small number of clinical variables obtainable prior to the procedure, without knowledge of the coronary anatomy.

Keywords: coronary intervention(PCI); interventional cardiology; risk stratification

Conflict of interest statement

Competing interests: None declared.

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