Validation of the Mayo Clinic Percutaneous Coronary Intervention Risk Prediction Score in Patients With Acute Coronary Syndrome.

IF 5.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Heart Association Pub Date : 2025-10-09 DOI:10.1161/JAHA.125.043012

Antonio Landi, Andrea Zito, Mandeep Singh, Dominick J Angiolillo, Davide Capodanno, Enrico Frigoli, Andrea Milzi, Sunil V Rao, Philip Urban, Marco Valgimigli

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引用次数: 0

Abstract

Background: A contemporary, comprehensive risk score for the prediction of in-hospital fatal and nonfatal adverse events after percutaneous coronary intervention has been recently developed, albeit its external validation in patients with acute coronary syndrome is lacking. The objective of this study is to validate the Mayo Clinic integer risk score in a large cohort of patients with acute coronary syndrome undergoing percutaneous coronary intervention from the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial.

Methods: The risk score is composed of a common set of 23 clinical and procedural variables (model A) and 18 preprocedural variables (model B). The primary objective was to appraise the receiver-operator characteristics of both models for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke. The impact of risk score categories on 1-year outcomes was also investigated.

Results: Among the 6724 patients undergoing percutaneous coronary intervention in the MATRIX trial, the receiver-operator characteristics-area under the curves for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke were 0.88 (95% CI, 0.85-0.91), 0.66 (95% CI, 0.63-0.69), 0.70 (95% CI, 0.67-0.72), and 0.65 (95% CI, 0.52-0.78) for model A and 0.88 (95% CI, 0.84-0.92), 0.63 (95% CI, 0.60-0.66), 0.66 (95% CI, 0.63-0.69), and 0.65 (95% CI, 0.52-0.78) for model B, respectively. Mortality (model A), bleeding, and stroke risks were well calibrated, whereas mortality (model B) and contrast-associated acute kidney injury risk were underestimated. There was a gradual risk increase for 1-year mortality and bleeding as a function of the risk score tertile using both models.

Conclusions: The risk score identifies patients with acute coronary syndrome at incremental risk of in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke, representing a valuable tool for mitigation of modifiable risk factors.

Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01433627.

查看原文本刊更多论文

梅奥诊所经皮冠状动脉介入治疗对急性冠状动脉综合征患者风险预测评分的验证。

背景：一种预测经皮冠状动脉介入治疗后住院致死性和非致死性不良事件的当代综合风险评分方法最近得到了发展，尽管其在急性冠状动脉综合征患者中的外部验证尚缺乏。本研究的目的是验证梅奥诊所在一个大队列急性冠状动脉综合征患者中进行的经皮冠状动脉介入治疗的整数风险评分，该队列来自MATRIX（通过经桡动脉通路和全身实施血管造影最小化不良出血事件）试验。方法：风险评分由23个临床和程序变量（模型a）和18个程序前变量（模型B）组成。主要目的是评估两种模型在住院死亡率、出血、造影剂相关急性肾损伤和中风方面的受体-操作者特征。风险评分类别对1年预后的影响也进行了调查。结果:在MATRIX试验中接受经皮冠状动脉介入治疗的6724例患者中，A模型的受者-操作者特征曲线下面积为0.88 （95% CI, 0.85-0.91）、0.66 （95% CI, 0.63-0.69）、0.70 （95% CI, 0.67-0.72）和0.65 (95% CI, 0.52-0.78)， B模型为0.88 （95% CI, 0.84-0.92）、0.63 （95% CI, 0.60-0.66）、0.66 （95% CI, 0.63-0.69）和0.65 （95% CI, 0.52-0.78）。分别。死亡率（模型A）、出血和卒中风险被很好地校准，而死亡率（模型B）和对比剂相关的急性肾损伤风险被低估。使用两种模型，1年死亡率和出血的风险逐渐增加，作为风险评分的函数。结论：风险评分识别出急性冠状动脉综合征患者在院内死亡、出血、造影剂相关急性肾损伤和中风的风险增加，是减轻可改变危险因素的有价值的工具。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT01433627。

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来源期刊

Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

1.90%

发文量

1749

审稿时长

12 weeks

期刊介绍： As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.