Predicting 1-, 3- and 5-year outcomes in patients with coronary artery disease: A comparison of available risk assessment scores.
Coronary artery disease
Haemorrhage
Ischemia
Prognosis
Risk assessment
Journal
Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
29
06
2020
revised:
14
11
2020
accepted:
10
12
2020
pubmed:
21
12
2020
medline:
24
6
2021
entrez:
20
12
2020
Statut:
ppublish
Résumé
Thromboischemic and bleeding events are rare but life-threatening complications after percutaneous coronary intervention (PCI). Various risk assessment models have been established to predict short- and long-term adverse events in patients with chronic and acute coronary syndromes (CCS, ACS). The aim of the present study was to compare available risk assessment systems based on their performance in identifying high-risk patients with symptomatic coronary artery disease (CAD). We enrolled 1565 consecutive patients with symptomatic CAD (n = 821 CCS, n = 744 ACS). CALIBER, DAPT, GRACE 2.0, PARIS-CTE, PARIS-MB, PRECISE-DAPT and PREDICT-STABLE scores were calculated in appropriate patient subgroups. All patients were followed-up for 1, 3 and 5 years for all-cause death (ACD), myocardial infarction (MI), ischemic stroke (IS) and bleeding. The primary combined ischemic endpoint (CE) consisted of ACD, MI and/or IS. Secondary endpoints were defined as single occurrence of either ACD, MI, IS, or bleeding. GRACE 2.0 score showed good discrimination performance (AUC>0.7) for CE in a 3- and 5-year follow-up. CALIBER, GRACE 2.0 and PARIS-CTE showed best performance (AUC>0.7) in predicting ACD throughout the follow-up, whereas IS was best predicted by PARIS-CTE and CALIBER scores. None of the scores performed well (AUC>0.7) in predicting MI or bleeding. In a consecutive German CAD cohort, CALIBER, GRACE 2.0 and PARIS-CTE scores performed best in predicting CE, ACD and/or IS whereas none of the selected scores could predict MI and bleeding efficiently.
Sections du résumé
BACKGROUND AND AIMS
Thromboischemic and bleeding events are rare but life-threatening complications after percutaneous coronary intervention (PCI). Various risk assessment models have been established to predict short- and long-term adverse events in patients with chronic and acute coronary syndromes (CCS, ACS). The aim of the present study was to compare available risk assessment systems based on their performance in identifying high-risk patients with symptomatic coronary artery disease (CAD).
METHODS
We enrolled 1565 consecutive patients with symptomatic CAD (n = 821 CCS, n = 744 ACS). CALIBER, DAPT, GRACE 2.0, PARIS-CTE, PARIS-MB, PRECISE-DAPT and PREDICT-STABLE scores were calculated in appropriate patient subgroups. All patients were followed-up for 1, 3 and 5 years for all-cause death (ACD), myocardial infarction (MI), ischemic stroke (IS) and bleeding. The primary combined ischemic endpoint (CE) consisted of ACD, MI and/or IS. Secondary endpoints were defined as single occurrence of either ACD, MI, IS, or bleeding.
RESULTS
GRACE 2.0 score showed good discrimination performance (AUC>0.7) for CE in a 3- and 5-year follow-up. CALIBER, GRACE 2.0 and PARIS-CTE showed best performance (AUC>0.7) in predicting ACD throughout the follow-up, whereas IS was best predicted by PARIS-CTE and CALIBER scores. None of the scores performed well (AUC>0.7) in predicting MI or bleeding.
CONCLUSIONS
In a consecutive German CAD cohort, CALIBER, GRACE 2.0 and PARIS-CTE scores performed best in predicting CE, ACD and/or IS whereas none of the selected scores could predict MI and bleeding efficiently.
Identifiants
pubmed: 33341519
pii: S0021-9150(20)31570-7
doi: 10.1016/j.atherosclerosis.2020.12.007
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-7Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.