Predictive ability of ACEF and ACEF II score in patients undergoing percutaneous coronary intervention in the GLOBAL LEADERS study.

Chichareon, Ply; Modolo, Rodrigo; van Klaveren, David; Takahashi, Kuniaki; Kogame, Norihiro; Chang, Chun-Chin; Katagiri, Yuki; Tomaniak, Mariusz; Asano, Taku; Spitzer, Ernest; Buszman, Pawel; Prokopczuk, Janusz; Fath-Ordoubadi, Farzin; Buysschaert, Ian; Anderson, Richard; Oldroyd, Keith G; Merkely, Bela; Garg, Scot; Wykrzykowska, Joanna J; Piek, Jan J; ... (2019). Predictive ability of ACEF and ACEF II score in patients undergoing percutaneous coronary intervention in the GLOBAL LEADERS study. International journal of cardiology, 286, pp. 43-50. Elsevier 10.1016/j.ijcard.2019.02.043

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BACKGROUND ACEF score has been shown to have predictive ability in the patients undergoing percutaneous coronary intervention (PCI). The ACEF II score has recently been developed to predict short-term mortality after cardiac surgery. We compared the predictive ability of the ACEF and ACEF II scores to predict mortality after PCI in the all-comers population. METHODS The ACEF and ACEF II scores were calculated in 15,968 patients enrolled in the GLOBAL LEADERS study. Discrimination and calibration were assessed for outcomes after PCI. Recalibration of the regression model by updating the intercept and slope were performed to adjust the original ACEF model to the PCI setting. In a stratified approach, patients were divided into quintiles according to the score. Outcomes were compared between quintiles. RESULTS The ACEF and ACEF II score were available in 14,941 and 14,355 patients respectively. Discrimination for 30-day all-cause mortality was acceptable for both scores (C-statistic ACEF 0.75 and ACEF II 0.77). For 2-year all-cause mortality, the discrimination of ACEF score was acceptable (C-statistic 0.72) while the discrimination of ACEF II score was moderate (C-statistic 0.69). Both scores identified patients at high risk of mortality but overestimated all-cause mortality at 30 days in all quintiles. After recalibration, agreement between predicted and observed 30-day all-cause mortality in both scores are close to the identity line. CONCLUSIONS The ACEF II model did not improve the predictive ability of the ACEF score. Recalibrated ACEF model can be used to estimated all-cause mortality rate at 30 days after PCI.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Valgimigli, Marco and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Amanda Valle

Date Deposited:

08 Aug 2019 08:05

Last Modified:

22 Oct 2019 23:56

Publisher DOI:

10.1016/j.ijcard.2019.02.043

PubMed ID:

30846254

Uncontrolled Keywords:

ACEF ACEF II GLOBAL LEADERS Mortality Percutaneous coronary intervention

BORIS DOI:

10.7892/boris.131795

URI:

https://boris.unibe.ch/id/eprint/131795

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