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National Cardiovascular Data Registry Model Predicts Long-Term Mortality in Patients Undergoing Percutaneous Coronary
Pradyumna Agasthi1, Chieh-Ju Chao2, Panwen Wang3
1Department of Cardiovascular Disease, Mayo Clinic, Phoenix, Arizona, USA, pradyumna_agasthi@hotmail.com.
Insights
The National Cardiovascular Data Registry (NCDR) model accurately predicts short- and long-term all-cause mortality in patients undergoing percutaneous coronary intervention (PCI). This validated model aids in assessing patient risk post-PCI.
Area of Science:
- Cardiovascular Medicine
- Health Services Research
Background:
- The National Cardiovascular Data Registry (NCDR) logistic regression model is established for predicting in-hospital mortality after percutaneous coronary intervention (PCI).
- Its utility for predicting long-term all-cause mortality following PCI has not been previously evaluated.
Discussion:
- This study assessed the NCDR model's ability to predict 6-month, 1-year, 2-year, and 5-year all-cause mortality in a large cohort of patients undergoing PCI.
- The model demonstrated strong predictive performance across all time points, with Area Under the Curve (AUC) values ranging from 0.78 to 0.84.
Key Insights:
- The NCDR model accurately predicts both short-term and long-term all-cause mortality after percutaneous coronary intervention.
- The model's predictive capability remains robust for up to 5 years post-PCI, indicating its value for long-term risk stratification.
- Analysis included 17,356 patients from the Mayo Clinic CathPCI registry, excluding those who underwent coronary artery bypass graft surgery.
Outlook:
- The findings support the broader application of the NCDR model for predicting long-term outcomes in patients undergoing PCI.
- Further research could explore model refinement or adaptation for specific patient subgroups to enhance personalized risk assessment.
- This validation encourages the use of existing registry data for comprehensive mortality risk prediction in interventional cardiology.
Abstract:
National Cardiovascular Data Registry (NCDR)-based logistic regression model is available for clinicians to predict in-hospital all-cause mortality after a percutaneous coronary intervention (PCI). However, this model has never been used to predict long-term all-cause mortality after PCI. Therefore, we sought to test the ability of the NCDR model to predict the short- and long-term risk of all-cause mortality in patients undergoing PCI. All patients undergoing PCI in the Mayo Clinic Health System were enrolled in the Mayo Clinic CathPCI registry. Patient-level demographic, clinical, and angiographic data from January 2006 to December 2017 were extracted from the registry. Patients who underwent coronary artery bypass graft surgery (CABG) were excluded. The area under the receiver operator characteristic curve (AUC) was calculated to assess the ability of the NCDR model to predict outcomes of interest (6-month, 1-year, 2-year, and 5-year all-cause mortality) after PCI. A total of 17,356 unique patients were included for the final analysis after excluding 165 patients who underwent CABG surgery. The mean age was 66.9 ± 12.5 years, and 71% were men. The 6-month, 1-year, 2-year, and 5-year all-cause mortality rates were 4.2% (n = 737), 5.8% (n = 1,005), 8.06% (n = 1,399), and 14.2% (n = 2,472), respectively. The AUCs of the NCDR model to predict 6-month, 1-year, 2-year, and 5-year all-cause mortality were 0.84 (95% CI: 0.82-0.86), 0.82 (95% CI: 0.80-0.84), 0.80 (95% CI: 0.79-0.81), and 0.78 (95% CI: 0.77-0.79), respectively. The NCDR model was able to accurately predict both short- and long-term all-cause mortality after PCI.
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