Predictive ability of ACEF and ACEF II score in patients undergoing percutaneous coronary intervention in the GLOBAL LEADERS study. (1st July 2019)

• Record Type: Journal Article
• Authors: Chichareon, Ply; Modolo, Rodrigo; van Klaveren, David; Takahashi, Kuniaki; Kogame, Norihiro; Chang, Chun-Chin; Katagiri, Yuki; Tomaniak, Mariusz; Asano, Taku; Spitzer, Ernest; Buszman, Pawel; Prokopczuk, Janusz; Fath-Ordoubadi, Farzin; Buysschaert, Ian; Anderson, Richard; Oldroyd, Keith G.; Merkely, Bela; Garg, Scot; Wykrzykowska, Joanna J.; Piek, Jan J.; Jüni, Peter; Hamm, Christian; Steg, Philippe Gabriel; Valgimigli, Marco; Vranckx, Pascal; Windecker, Stephan; Onuma, Yoshinobu; Serruys, Patrick W.
• Is Part Of: International journal of cardiology. Volume 286(2019)
• Page Start: 43
• Page End: 50
• Publication Date: 2019-07-01
• Subjects: ACEF age, creatinine and ejection fraction -- ACS acute coronary syndrome -- BARC bleeding academic research consortium -- CABG coronary artery bypass graft surgery -- LVEF left ventricular ejection fraction -- NACE net adverse clinical events -- NSTEMI non-ST-segment elevation myocardial infarction -- PCI percutaneous coronary intervention -- POCE patient oriented composite endpoints -- STEMI ST-segment elevation myocardial infarction; ACEF -- ACEF II -- Mortality -- Percutaneous coronary intervention -- GLOBAL LEADERS; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2019.02.043
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: ACEF score has been shown to have predictive ability in the patients undergoing percutaneous coronary intervention (PCI). The ACEF II score has recently been developed to predict short-term mortality after cardiac surgery. We compared the predictive ability of the ACEF and ACEF II scores to predict mortality after PCI in the all-comers population. Methods: The ACEF and ACEF II scores were calculated in 15, 968 patients enrolled in the GLOBAL LEADERS study. Discrimination and calibration were assessed for outcomes after PCI. Recalibration of the regression model by updating the intercept and slope were performed to adjust the original ACEF model to the PCI setting. In a stratified approach, patients were divided into quintiles according to the score. Outcomes were compared between quintiles. Results: The ACEF and ACEF II score were available in 14, 941 and 14, 355 patients respectively. Discrimination for 30-day all-cause mortality was acceptable for both scores (C-statistic ACEF 0.75 and ACEF II 0.77). For 2-year all-cause mortality, the discrimination of ACEF score was acceptable (C-statistic 0.72) while the discrimination of ACEF II score was moderate (C-statistic 0.69). Both scores identified patients at high risk of mortality but overestimated all-cause mortality at 30 days in all quintiles. After recalibration, agreement between predicted and observed 30-day all-cause mortality in both scores are close to the identity line. Conclusions: The ACEF II model did not improve the predictive ability of the ACEF score. Recalibrated ACEF model can be used to estimated all-cause mortality rate at 30 days after PCI. Highlights: The ACEF II score did not improve the predictive ability of the ACEF score in patients undergoing PCI. The parsimonious ACEF score is still a valuable tool to predict outcomes and identify patients at high risk after PCI. Recalibrated ACEF model can be used to estimated all-cause mortality rate at 30 days after PCI.