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Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry.

Publication ,  Journal Article
Peterson, ED; Dai, D; DeLong, ER; Brennan, JM; Singh, M; Rao, SV; Shaw, RE; Roe, MT; Ho, KKL; Klein, LW; Krone, RJ; Weintraub, WS ...
Published in: J Am Coll Cardiol
May 4, 2010

OBJECTIVES: We sought to create contemporary models for predicting mortality risk following percutaneous coronary intervention (PCI). BACKGROUND: There is a need to identify PCI risk factors and accurately quantify procedural risks to facilitate comparative effectiveness research, provider comparisons, and informed patient decision making. METHODS: Data from 181,775 procedures performed from January 2004 to March 2006 were used to develop risk models based on pre-procedural and/or angiographic factors using logistic regression. These models were independently evaluated in 2 validation cohorts: contemporary (n = 121,183, January 2004 to March 2006) and prospective (n = 285,440, March 2006 to March 2007). RESULTS: Overall, PCI in-hospital mortality was 1.27%, ranging from 0.65% in elective PCI to 4.81% in ST-segment elevation myocardial infarction patients. Multiple pre-procedural clinical factors were significantly associated with in-hospital mortality. Angiographic variables provided only modest incremental information to pre-procedural risk assessments. The overall National Cardiovascular Data Registry (NCDR) model, as well as a simplified NCDR risk score (based on 8 key pre-procedure factors), had excellent discrimination (c-index: 0.93 and 0.91, respectively). Discrimination and calibration of both risk tools were retained among specific patient subgroups, in the validation samples, and when used to estimate 30-day mortality rates among Medicare patients. CONCLUSIONS: Risks for early mortality following PCI can be accurately predicted in contemporary practice. Incorporation of such risk tools should facilitate research, clinical decisions, and policy applications.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 4, 2010

Volume

55

Issue

18

Start / End Page

1923 / 1932

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Risk Adjustment
  • Reproducibility of Results
  • Registries
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
 

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Peterson, E. D., Dai, D., DeLong, E. R., Brennan, J. M., Singh, M., Rao, S. V., … NCDR Registry Participants, . (2010). Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry. J Am Coll Cardiol, 55(18), 1923–1932. https://doi.org/10.1016/j.jacc.2010.02.005
Peterson, Eric D., David Dai, Elizabeth R. DeLong, J Matthew Brennan, Mandeep Singh, Sunil V. Rao, Richard E. Shaw, et al. “Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry.J Am Coll Cardiol 55, no. 18 (May 4, 2010): 1923–32. https://doi.org/10.1016/j.jacc.2010.02.005.
Peterson ED, Dai D, DeLong ER, Brennan JM, Singh M, Rao SV, et al. Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry. J Am Coll Cardiol. 2010 May 4;55(18):1923–32.
Peterson, Eric D., et al. “Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry.J Am Coll Cardiol, vol. 55, no. 18, May 2010, pp. 1923–32. Pubmed, doi:10.1016/j.jacc.2010.02.005.
Peterson ED, Dai D, DeLong ER, Brennan JM, Singh M, Rao SV, Shaw RE, Roe MT, Ho KKL, Klein LW, Krone RJ, Weintraub WS, Brindis RG, Rumsfeld JS, Spertus JA, NCDR Registry Participants. Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National Cardiovascular Data Registry. J Am Coll Cardiol. 2010 May 4;55(18):1923–1932.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 4, 2010

Volume

55

Issue

18

Start / End Page

1923 / 1932

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Risk Adjustment
  • Reproducibility of Results
  • Registries
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male