April 14, 2003Circulation
Modeling and Risk Prediction in the Current Era of Interventional Cardiology
Key result
Application of 5 pre-stent era mortality risk models to 4448 PCI patients showed that 3 models predicted mortality rates (1.3%-1.7%) not significantly different from the observed 1.4% rate.
Why the study?
Do multivariable mortality models developed during the pre-stent era accurately predict in-hospital mortality in patients undergoing percutaneous coronary intervention in the current era?
Population
4,448 patients undergoing percutaneous coronary intervention in the 1997 to 1999 National Heart, Lung, and…
Comparison
Application of 5 multivariable mortality risk… vs Observed in-hospital mortality
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
Select pre-stent models may still predict contemporary PCI mortality; extends applicability but warrants prospective validation.
Study Design
Type
Observational (n=4,448)
Multicenter
Yes
Structured PICO
Do multivariable mortality models developed during the pre-stent era accurately predict in-hospital mortality in patients undergoing percutaneous coronary intervention in the current era?
P
Population
4,448 patients undergoing percutaneous coronary intervention in the 1997 to 1999 National Heart, Lung, and Blood Institute Dynamic Registry (73% received ≥1 stent, 28% received a IIB/IIIA receptor inhibitor)
I
Intervention
Application of 5 multivariable mortality risk models developed during the pre-stent era (New York State, ACC-NCDR, Northern New England Cooperative Group, Cleveland Clinic Foundation, and University of Michigan)
C
Comparator
Observed in-hospital mortality
O
Outcome
In-hospital mortalityhard clinical
Three out of five pre-stent era mortality risk models accurately predicted in-hospital mortality in a contemporary PCI cohort, whereas the ACC Registry model significantly overpredicted risk.
Cite This Study
Holmes et al. (2003) conducted an observational in Percutaneous coronary intervention (n=4,448). 5 mortality risk models (New York State, ACC-NCDR, Northern New England, Cleveland Clinic, University of Michigan) vs. Observed in-hospital mortality was evaluated on In-hospital mortality. Application of 5 pre-stent era mortality risk models to 4448 PCI patients showed that 3 models predicted mortality rates (1.3%-1.7%) not significantly different from the observed 1.4% rate.