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

van Boven, Nick; van Domburg, Ron T; Kardys, Isabella; Umans, Victor A; Akkerhuis, K Martijn; Lenzen, Mattie J; Valgimigli, Marco; Daemen, Joost; Zijlstra, Felix; Boersma, Eric; van Geuns, Robert-Jan (2018). Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study. Catheterization and cardiovascular interventions, 91(4), pp. 686-695. Wiley-Blackwell 10.1002/ccd.27182

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Valgimigli, Marco

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Amanda Valle

Date Deposited:

03 Aug 2018 14:55

Last Modified:

24 Oct 2019 06:14

Publisher DOI:

10.1002/ccd.27182

PubMed ID:

28707322

Uncontrolled Keywords:

prognosis coronary artery disease stents

BORIS DOI:

10.7892/boris.119037

URI:

https://boris.unibe.ch/id/eprint/119037

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