Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score

Ply Chichareon; David van Klaveren; Rodrigo Modolo; Norihiro Kogame; Kuniaki Takahashi; Chun Chin Chang; Mariusz Tomaniak; Jinqing Yuan; Lihua Xie; Ying Song; Shubin Qiao; Yuejin Yang; Changdong Guan; Aleksander Zurakowski; Robert Jan van Geuns; Manel Sabate; Paul J. Ong; Joanna J. Wykrzykowska; Jan J. Piek; Scot Garg; Christian Hamm; Gabriel Steg; Pascal Vranckx; Marco Valgimigli; Stephan Windecker; Peter Juni; Yoshinobu Onuma; Ewout Steyerberg; Bo Xu; Patrick W. Serruys

doi:10.1002/ccd.29490

Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score

Ply Chichareon, David van Klaveren, Rodrigo Modolo, Norihiro Kogame, Kuniaki Takahashi, Chun Chin Chang, Mariusz Tomaniak, Jinqing Yuan, Lihua Xie, Ying Song, Shubin Qiao, Yuejin Yang, Changdong Guan, Aleksander Zurakowski, Robert Jan van Geuns, Manel Sabate, Paul J. Ong, Joanna J. Wykrzykowska, Jan J. Piek, Scot GargChristian Hamm, Gabriel Steg, Pascal Vranckx, Marco Valgimigli, Stephan Windecker, Peter Juni, Yoshinobu Onuma, Ewout Steyerberg, Bo Xu^*, Patrick W. Serruys

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

8 Citations (Scopus)

Abstract

Aims: We aimed to update the logistic clinical SYNTAX score to predict 2 year all-cause mortality after contemporary percutaneous coronary intervention (PCI). Methods and results: We analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The logistic clinical SYNTAX model was updated after imputing missing values by refitting the original model (refitted original model) and fitting an extended new model (new model, with, selection based on the Akaike Information Criterion). External validation was performed in 10,100 patients having PCI at Fu Wai hospital. Chronic obstructive pulmonary disease, prior stroke, current smoker, hemoglobin level, and white blood cell count were identified as additional independent predictors of 2 year all-cause mortality and included into the new model. The c-indexes of the original, refitted original and the new model in the derivation cohort were 0.74 (95% CI 0.72–0.76), 0.75 (95% CI 0.73–0.77), and 0.78 (95% CI 0.76–0.80), respectively. The c-index of the new model was lower in the validation cohort than in the derivation cohort, but still showed improved discriminative ability of the newly developed model (0.72; 95% CI 0.67–0.77) compared to the refitted original model (0.69; 95% CI 0.64–0.74). The models overestimated the observed 2 year all-cause mortality of 1.11% in the Chinese external validation cohort by 0.54 percentage points, indicating the need for calibration of the model to the Chinese patient population. Conclusions: The new model of the logistic clinical SYNTAX score better predicts 2 year all-cause mortality after PCI than the original model. The new model could guide clinical decision making by risk stratifying patients undergoing PCI.

Original language	English
Pages (from-to)	1287-1297
Number of pages	11
Journal	Catheterization and Cardiovascular Interventions
Volume	98
Issue number	7
Early online date	4 Feb 2021
DOIs	https://doi.org/10.1002/ccd.29490
Publication status	Published - 1 Dec 2021

Bibliographical note

Funding Information:
GLOBAL LEADERS study was sponsored by the European Clinical Research Institute, which received funding from Biosensors International, AstraZeneca, and the Medicines Company. The study funders had no role in trial design, data collection, analysis, interpretation of the data, preparation, approval, or making a decision to submit the manuscript or publication.

Funding Information:
Dr. Windecker reports research and educational grants from Amgen, Abbott, Bayer, BMS, Boston Scientific, Biotronik, CSL Behring, Medtronic, Edwards Lifesciences, Polares and Sinomed.

Funding Information:
Dr. Chichareon reports research grant from Biosensors International outside the submitted work.

Funding Information:
Dr. Modolo received research grant from Biosensors and from the Sao Paulo Research Foundation (FAPESP‐grant number 2017/22013–8).

Funding Information:
Dr. van Geuns, received speakers fee from Abbott Vascular. The Thoraxcenter, ErasmusMC, Rotterdam received research grants from Abbott Vascular and Boston Scientific.

Publisher Copyright:
© 2021 Wiley Periodicals LLC.

Access to Document

10.1002/ccd.29490Licence: Unspecified

Cite this

Chichareon, P., van Klaveren, D., Modolo, R., Kogame, N., Takahashi, K., Chang, C. C., Tomaniak, M., Yuan, J., Xie, L., Song, Y., Qiao, S., Yang, Y., Guan, C., Zurakowski, A., van Geuns, R. J., Sabate, M., Ong, P. J., Wykrzykowska, J. J., Piek, J. J., ... Serruys, P. W. (2021). Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score. Catheterization and Cardiovascular Interventions, 98(7), 1287-1297. https://doi.org/10.1002/ccd.29490

@article{757c6d535dbf49829e8b60feeb5c6d06,

title = "Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score",

abstract = "Aims: We aimed to update the logistic clinical SYNTAX score to predict 2 year all-cause mortality after contemporary percutaneous coronary intervention (PCI). Methods and results: We analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The logistic clinical SYNTAX model was updated after imputing missing values by refitting the original model (refitted original model) and fitting an extended new model (new model, with, selection based on the Akaike Information Criterion). External validation was performed in 10,100 patients having PCI at Fu Wai hospital. Chronic obstructive pulmonary disease, prior stroke, current smoker, hemoglobin level, and white blood cell count were identified as additional independent predictors of 2 year all-cause mortality and included into the new model. The c-indexes of the original, refitted original and the new model in the derivation cohort were 0.74 (95% CI 0.72–0.76), 0.75 (95% CI 0.73–0.77), and 0.78 (95% CI 0.76–0.80), respectively. The c-index of the new model was lower in the validation cohort than in the derivation cohort, but still showed improved discriminative ability of the newly developed model (0.72; 95% CI 0.67–0.77) compared to the refitted original model (0.69; 95% CI 0.64–0.74). The models overestimated the observed 2 year all-cause mortality of 1.11% in the Chinese external validation cohort by 0.54 percentage points, indicating the need for calibration of the model to the Chinese patient population. Conclusions: The new model of the logistic clinical SYNTAX score better predicts 2 year all-cause mortality after PCI than the original model. The new model could guide clinical decision making by risk stratifying patients undergoing PCI.",

author = "Ply Chichareon and {van Klaveren}, David and Rodrigo Modolo and Norihiro Kogame and Kuniaki Takahashi and Chang, {Chun Chin} and Mariusz Tomaniak and Jinqing Yuan and Lihua Xie and Ying Song and Shubin Qiao and Yuejin Yang and Changdong Guan and Aleksander Zurakowski and {van Geuns}, {Robert Jan} and Manel Sabate and Ong, {Paul J.} and Wykrzykowska, {Joanna J.} and Piek, {Jan J.} and Scot Garg and Christian Hamm and Gabriel Steg and Pascal Vranckx and Marco Valgimigli and Stephan Windecker and Peter Juni and Yoshinobu Onuma and Ewout Steyerberg and Bo Xu and Serruys, {Patrick W.}",

note = "Funding Information: GLOBAL LEADERS study was sponsored by the European Clinical Research Institute, which received funding from Biosensors International, AstraZeneca, and the Medicines Company. The study funders had no role in trial design, data collection, analysis, interpretation of the data, preparation, approval, or making a decision to submit the manuscript or publication. Funding Information: Dr. Windecker reports research and educational grants from Amgen, Abbott, Bayer, BMS, Boston Scientific, Biotronik, CSL Behring, Medtronic, Edwards Lifesciences, Polares and Sinomed. Funding Information: Dr. Chichareon reports research grant from Biosensors International outside the submitted work. Funding Information: Dr. Modolo received research grant from Biosensors and from the Sao Paulo Research Foundation (FAPESP‐grant number 2017/22013–8). Funding Information: Dr. van Geuns, received speakers fee from Abbott Vascular. The Thoraxcenter, ErasmusMC, Rotterdam received research grants from Abbott Vascular and Boston Scientific. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC.",

year = "2021",

month = dec,

day = "1",

doi = "10.1002/ccd.29490",

language = "English",

volume = "98",

pages = "1287--1297",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "John Wiley & Sons Inc.",

number = "7",

}

Chichareon, P, van Klaveren, D, Modolo, R, Kogame, N, Takahashi, K, Chang, CC, Tomaniak, M, Yuan, J, Xie, L, Song, Y, Qiao, S, Yang, Y, Guan, C, Zurakowski, A, van Geuns, RJ, Sabate, M, Ong, PJ, Wykrzykowska, JJ, Piek, JJ, Garg, S, Hamm, C, Steg, G, Vranckx, P, Valgimigli, M, Windecker, S, Juni, P, Onuma, Y, Steyerberg, E, Xu, B & Serruys, PW 2021, 'Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score', Catheterization and Cardiovascular Interventions, vol. 98, no. 7, pp. 1287-1297. https://doi.org/10.1002/ccd.29490

TY - JOUR

T1 - Predicting 2-year all-cause mortality after contemporary PCI

T2 - Updating the logistic clinical SYNTAX score

AU - Chichareon, Ply

AU - van Klaveren, David

AU - Modolo, Rodrigo

AU - Kogame, Norihiro

AU - Takahashi, Kuniaki

AU - Chang, Chun Chin

AU - Tomaniak, Mariusz

AU - Yuan, Jinqing

AU - Xie, Lihua

AU - Song, Ying

AU - Qiao, Shubin

AU - Yang, Yuejin

AU - Guan, Changdong

AU - Zurakowski, Aleksander

AU - van Geuns, Robert Jan

AU - Sabate, Manel

AU - Ong, Paul J.

AU - Wykrzykowska, Joanna J.

AU - Piek, Jan J.

AU - Garg, Scot

AU - Hamm, Christian

AU - Steg, Gabriel

AU - Vranckx, Pascal

AU - Valgimigli, Marco

AU - Windecker, Stephan

AU - Juni, Peter

AU - Onuma, Yoshinobu

AU - Steyerberg, Ewout

AU - Xu, Bo

AU - Serruys, Patrick W.

N1 - Funding Information: GLOBAL LEADERS study was sponsored by the European Clinical Research Institute, which received funding from Biosensors International, AstraZeneca, and the Medicines Company. The study funders had no role in trial design, data collection, analysis, interpretation of the data, preparation, approval, or making a decision to submit the manuscript or publication. Funding Information: Dr. Windecker reports research and educational grants from Amgen, Abbott, Bayer, BMS, Boston Scientific, Biotronik, CSL Behring, Medtronic, Edwards Lifesciences, Polares and Sinomed. Funding Information: Dr. Chichareon reports research grant from Biosensors International outside the submitted work. Funding Information: Dr. Modolo received research grant from Biosensors and from the Sao Paulo Research Foundation (FAPESP‐grant number 2017/22013–8). Funding Information: Dr. van Geuns, received speakers fee from Abbott Vascular. The Thoraxcenter, ErasmusMC, Rotterdam received research grants from Abbott Vascular and Boston Scientific. Publisher Copyright: © 2021 Wiley Periodicals LLC.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Aims: We aimed to update the logistic clinical SYNTAX score to predict 2 year all-cause mortality after contemporary percutaneous coronary intervention (PCI). Methods and results: We analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The logistic clinical SYNTAX model was updated after imputing missing values by refitting the original model (refitted original model) and fitting an extended new model (new model, with, selection based on the Akaike Information Criterion). External validation was performed in 10,100 patients having PCI at Fu Wai hospital. Chronic obstructive pulmonary disease, prior stroke, current smoker, hemoglobin level, and white blood cell count were identified as additional independent predictors of 2 year all-cause mortality and included into the new model. The c-indexes of the original, refitted original and the new model in the derivation cohort were 0.74 (95% CI 0.72–0.76), 0.75 (95% CI 0.73–0.77), and 0.78 (95% CI 0.76–0.80), respectively. The c-index of the new model was lower in the validation cohort than in the derivation cohort, but still showed improved discriminative ability of the newly developed model (0.72; 95% CI 0.67–0.77) compared to the refitted original model (0.69; 95% CI 0.64–0.74). The models overestimated the observed 2 year all-cause mortality of 1.11% in the Chinese external validation cohort by 0.54 percentage points, indicating the need for calibration of the model to the Chinese patient population. Conclusions: The new model of the logistic clinical SYNTAX score better predicts 2 year all-cause mortality after PCI than the original model. The new model could guide clinical decision making by risk stratifying patients undergoing PCI.

AB - Aims: We aimed to update the logistic clinical SYNTAX score to predict 2 year all-cause mortality after contemporary percutaneous coronary intervention (PCI). Methods and results: We analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The logistic clinical SYNTAX model was updated after imputing missing values by refitting the original model (refitted original model) and fitting an extended new model (new model, with, selection based on the Akaike Information Criterion). External validation was performed in 10,100 patients having PCI at Fu Wai hospital. Chronic obstructive pulmonary disease, prior stroke, current smoker, hemoglobin level, and white blood cell count were identified as additional independent predictors of 2 year all-cause mortality and included into the new model. The c-indexes of the original, refitted original and the new model in the derivation cohort were 0.74 (95% CI 0.72–0.76), 0.75 (95% CI 0.73–0.77), and 0.78 (95% CI 0.76–0.80), respectively. The c-index of the new model was lower in the validation cohort than in the derivation cohort, but still showed improved discriminative ability of the newly developed model (0.72; 95% CI 0.67–0.77) compared to the refitted original model (0.69; 95% CI 0.64–0.74). The models overestimated the observed 2 year all-cause mortality of 1.11% in the Chinese external validation cohort by 0.54 percentage points, indicating the need for calibration of the model to the Chinese patient population. Conclusions: The new model of the logistic clinical SYNTAX score better predicts 2 year all-cause mortality after PCI than the original model. The new model could guide clinical decision making by risk stratifying patients undergoing PCI.

UR - http://www.scopus.com/inward/record.url?scp=85100502887&partnerID=8YFLogxK

U2 - 10.1002/ccd.29490

DO - 10.1002/ccd.29490

M3 - Article

C2 - 33539048

AN - SCOPUS:85100502887

SN - 1522-1946

VL - 98

SP - 1287

EP - 1297

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 7

ER -

Predicting 2-year all-cause mortality after contemporary PCI: Updating the logistic clinical SYNTAX score

Abstract

Bibliographical note

Access to Document

Other files and links

Fingerprint

Cite this