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July 8, 2026Journal of Cardiovascular Translational ResearchOpen Access

Predicting Mortality After Percutaneous Coronary Intervention in a Multiethnic Southeast Asian Population: Insights From Machine Learning

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Why the study?

Ischemic heart disease remains a major contributor to mortality in Malaysia, where non-elective PCI is frequently performed in high-risk ACS patients.

Can machine learning models accurately predict in-hospital, 30-day, and 1-year mortality in patients undergoing percutaneous coronary intervention?

Population

29,521 patients from a nationwide registry in Malaysia

Comparison

Seven machine learning models for predicting mortality

Design

Nationwide registry-based prognostic model development and validation study

Follow-up

1-year

Key result

Machine learning models demonstrated high discrimination for predicting in-hospital mortality after non-elective PCI, with ROC-AUC ranging from 0.927 to 0.943 in external validation.

Authors

YLYih Miin LiewYCYin Kia ChiamPNPei Ling Ngo

Discussion

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Member takes

Overview

ML models may aid ACS PCI mortality risk stratification; leaves open clinical utility pending prospective validation.

Key Points

  • This research aims to identify predictors of mortality after percutaneous coronary intervention in high-risk patients using machine learning models.
  • Analyzed nationwide registry data from 2007 to 2020, involving 29,521 patients.
  • Compared seven machine learning models for predicting mortality at different time points: in-hospital, 30-day, and 1-year.
  • Performed logistic recalibration and validated results using external cohorts (TEST1 and TEST2).
  • In-hospital mortality discrimination ranged from 0.927 to 0.943 in TEST1 and 0.865 to 0.884 in TEST2.
  • For 30-day mortality, ROC-AUC ranged from 0.902 to 0.923 in TEST1 and 0.753 to 0.838 in TEST2.
  • Key predictors consistently identified were age, haemodynamic status, and renal function.

Study Design

Type

Cohort (n=29,521)

Multicenter

Yes

Structured PICO

Can machine learning models accurately predict in-hospital, 30-day, and 1-year mortality in patients undergoing percutaneous coronary intervention?

P
Population
29,521 patients undergoing non-elective percutaneous coronary intervention for acute coronary syndrome from a nationwide registry in Malaysia (2007–2020).
E
Exposure
Seven machine learning (ML) models for predicting mortality
O
Outcome
In-hospital, 30-day, and 1-year mortalityhard clinical

Main Result

Effect estimate: ROC-AUC 0.927 to 0.943 (in-hospital, TEST1)

Machine learning models can accurately predict short- and long-term mortality following PCI in a multiethnic Southeast Asian population, identifying age, hemodynamic status, and renal function as key predictors.

Cite This Study

Liew et al. (2026) conducted a cohort in Ischemic heart disease / Acute coronary syndrome (n=29,521). Machine learning (ML) models was evaluated on In-hospital, 30-day, and 1-year mortality (ROC-AUC 0.927 to 0.943 (in-hospital, TEST1)). Machine learning models demonstrated high discrimination for predicting in-hospital mortality after non-elective PCI, with ROC-AUC ranging from 0.927 to 0.943 in external validation.

synapsesocial.com/papers/6a4de835d2ea289ef6282fbehttps://doi.org/10.1007/s12265-026-10812-5
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Also Consider

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