External Validation of the ACUITY/HORIZON Bleeding Risk Score among Acute Coronary Syndrome Patients in Thai PCI Registry

被引:1
|
作者
Roongsangmanoon, Worawut [1 ]
Chichareon, Ply [2 ]
Angkananard, Teeranan [1 ]
Suwannasom, Pannipa [3 ]
Chandavimol, Mann [4 ]
Limpijankit, Thosaphol [4 ]
Srimahachota, Suphot [5 ]
Athisakul, Siriporn [5 ]
Hutayanon, Pisit [6 ]
Kiatchoosakun, Songsak [7 ]
Thanakitcharu, Praprut [8 ]
Charoenpanichsunti, Montri [9 ]
Chamsaard, Prajongjit [10 ]
Siriyotha, Sukanya [11 ]
Thakkinstian, Ammarin [11 ]
Sansanayudh, Nakarin [12 ]
机构
[1] Srinakharinwirot Univ, Fac Med, Dept Med, Div Cardiol, Ongkharak Campus, Nakhon Nayok, Thailand
[2] Prince Songkla Univ, Fac Med, Dept Internal Med, Cardiol Unit, Hat Yai, Thailand
[3] Chiang Mai Univ, Fac Med, Northern Reg Heart Ctr, Chiang Mai, Thailand
[4] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Med, Bangkok, Thailand
[5] King Chulalongkorn Mem Hosp, Cardiac Ctr, Bangkok, Thailand
[6] Thammasat Univ, Fac Med, Dept Med, Cardiol Unit, Pathum Thani, Thailand
[7] Khonkaen Univ, Fac Med, Dept Med, Cardiol Unit, Khon Kaen, Khon Kaen, Thailand
[8] Sunpasitthiprasong Hosp Ubon Ratchathani, Cardiac Ctr, Ubon Ratchathani, Thailand
[9] Phyathai Sriracha Gen Hosp, Cardiac Ctr, Chon Buri, Thailand
[10] Bhumibol Adulyadej Hosp, Cardiol Unit, Bangkok, Thailand
[11] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Clin Epidemiol & Biostat, Bangkok, Thailand
[12] Phramongkutklao Hosp, Dept Med, Cardiol Unit, 315 Rachavithee Rd, Bangkok 10300, Thailand
关键词
ACUITY/HORIZON risk score; acute coronary syndrome; percutaneous coronary intervention; in-hospital major bleeding; ELEVATION MYOCARDIAL-INFARCTION; ACUITY-HORIZONS; CRUSADE; BIVALIRUDIN; INTERVENTION; PERFORMANCE; INSIGHTS; HEPARIN; OUTCOMES; COHORT;
D O I
10.1055/a-1964-8247
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background External validation is essential before implementing a predictive model in clinical practice. This analysis validated the performance of the ACUITY/HORIZON risk score in the most contemporary Thai PCI registry. Methods The ACUITY/HORIZON model was applied and validated externally in 12,268 ACS (acute coronary syndrome) patients. For revision and updating models, the regression coefficientd of all predictors were re-estimated and then additional predictors were stepwise selected from multivariate analysis. Results In-hospital bleeding defined by the BARC (Bleeding Academic Research Consortium) criteria was 1.3% (161 patients) and 2.3% (285 patients) by the ACUITY criteria. The calibration of both scales demonstrated overestimation of the original model with C-statistic values of 0.704 for ACUITY major bleeding and 0.793 for BARC 3 or 5 bleeding. For ACUITY major bleeding, the discriminatory power of the update model improved substantially when congestive heart failure (CHF), prior vascular disease as well as body mass index were considered. The update model demonstrated good calibration and C-statistic of 0.747 and 0.745 with no white blood cell (WBC) count. For BARC 3 or 5 bleeding, good calibration and discriminatory capacity could be observed when CHF and prior vascular disease were added in the update models, with an excellent C-statistic of 0.838, and a lower C-statistic value of 0.835 was obtained in the absence of WBC count. Conclusion The ACUITY/HORIZON score was successfully validated in contemporary predictive and risk-adjustment models for PCI-related bleeding. The update models had good operating characteristics in patients from a real-world ACS population irrespective of bleeding definitions.
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收藏
页码:255 / 266
页数:12
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