ELHT Evidence Hub
  • Home
  • Meet the Team
  • Library Facilities
  • Education, Research and Innovation
Picture

TCT-421 Predicting 2 Years All-Cause Mortality After Contemporary PCI: Revising and Updating the Logistic Clinical SYNTAX Score in the GLOBAL LEADERS Study

18/10/2019

0 Comments

 
Author(s) Chichareon P.; Modolo R.; Kogame N.; Takahashi K.; van Klaveren D. et al.
Source Journal of the American College of Cardiology; Oct 2019; vol. 74 (no. 13)
DOI 10.1016/j.jacc.2019.08.512
Background: The logistic clinical SYNTAX score combined anatomic SYNTAX score and 7 variables to predict 2-year all-cause mortality after percutaneous coronary intervention (PCI). The score was derived from 7 stent trials in which new-generation drug-eluting stent and potent antiplatelet inhibitors were not widely utilized. The original logistic clinical SYNTAX score has been shown to overestimate 2-year all-cause mortality in the GLOBAL LEADERS study. This study aimed to revise and update the logistic clinical SYNTAX score to predict 2-year all-cause mortality after contemporary PCI using the population in the GLOBAL LEADERS study.

Method(s): The authors analyzed 15,883 patients in the GLOBAL LEADERS study who underwent PCI. The original model of the logistic clinical SYNTAX score was revised by re-estimating the predictor effects in Cox regression model (revised model). The authors updated the score by combining the original model with additional independent predictors of 2-year mortality identified in the GLOBAL LEADERS study population (updated model). Internal validation with bootstrap method was used to quantify and correct for overfitting and optimism.

Result(s): This study has identified 5 additional independent predictors of 2-year all-cause mortality: hemoglobin level; white blood cell count; chronic obstructive pulmonary disease; prior stroke; and current smoker. The updated model (C-index: 0.78; 95% confidence interval [CI]: 0.76 to 0.80) better discriminated 2-year all-cause mortality than the previous version (C-index: 0.75; 95% CI: 0.73 to 0.77), in an internal validation using bootstrap method. The updated model performed better in differentiating mortality among non-high-risk patients. The calibration of both models was appropriate. Currently the updated model is tested in an external validation cohort of 10,724 patients.

​Conclusion(s): By adding 5 predictors to the logistic clinical SYNTAX score, the score better predicts 2-year all-cause mortality after PCI. The score can be used for risk stratification and prediction in patients undergoing PCI in the contemporary practice. Categories: CORONARY: Stents: Drug-ElutingCopyright © 2019
  • Available in full text at Journal of the American College of Cardiology from Unpaywall
0 Comments



Leave a Reply.

    The following databases were searched:
    EMBASE,  MEDLINE, PsycINFO, BNI, CINAHL, 
    to find  ELHT staff publications

    Specialties

    All
    ANAESTHETICS
    CARDIOLOGY
    COVID 19
    DERMATOLOGY
    DIABETES
    DIETETICS
    EMERGENCY CARE
    GYNAECOLOGY
    MAXILLOFACIAL
    NEONATOLOGY
    OBSTETRICS
    ONCOLOGY
    ORTHOPAEDICS
    PAEDIATRICS
    PAIN
    PHARMACY
    RADIOLOGY
    RESPIRATORY
    SURGERY
    UROLOGY
    VASCULAR SURGERY

    RSS Feed

    Archives - past 2 years

    December 2020
    November 2020
    October 2020
    September 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    January 2019
    December 2018

Learning Centre Library
Royal Blackburn Teaching Hospital
library.blackburn@elht.nhs.uk
01254 734312 or Ext 84312

​Find us

Staffed Opening Hours
Mon      08:30-16:30
Tue       08:30-16:30
Wed     08:30-16:30
Thu      08:30-16:30
Fri         08:30-16:00
Mackenzie Library
Burnley General Teaching Hospital
library.burnley@elht.nhs.uk
01282 803114 or Ext. 13114

Find us

Staffed Opening Hours
Mon      08:30-16:00
Tue       08:30-16:00
Wed     08:30-16:00
Thu       08:30-16:00
Fri         Unstaffed

FAQS
​Library Catalogue
Library @lerts
​Your Specialty or Professional Group
Membership Terms & Conditions
Privacy Policy
Our Performance
​Your Feedback
​Specialty Journals

Picture
Picture
24/7 access to the library is available - please see library staff
Picture
  • Home
  • Meet the Team
  • Library Facilities
  • Education, Research and Innovation