TY - JOUR
T1 - Validation of the updated logistic clinical SYNTAX score for all-cause mortality in the GLOBAL LEADERS trial
AU - Chichareon, Ply
AU - Onuma, Yoshinobu
AU - van Klaveren, David
AU - Modolo, Rodrigo
AU - Kogame, Norihiro
AU - Takahashi, Kuniaki
AU - Chang, Chun Chin
AU - Tomaniak, Mariusz
AU - Asano, Taku
AU - Katagiri, Yuki
AU - van Geuns, Robert-Jan M
AU - Bolognese, Leonardo
AU - Tumscitz, Carlo
AU - Vrolix, Mathias
AU - Petrov, Ivo
AU - Garg, Scot
AU - Naber, Christoph Kurt
AU - Sabaté, Manel
AU - Iqbal, Javaid
AU - Wykrzykowska, Joanna J
AU - Piek, Jan J
AU - Spitzer, Ernest
AU - Jüni, Peter
AU - Hamm, Christian
AU - Steg, Philippe Gabriel
AU - Valgimigli, Marco
AU - Vranckx, Pascal
AU - Windecker, Stephan
AU - Serruys, Patrick W
PY - 2019/8/9
Y1 - 2019/8/9
N2 - AIMS: The aim of this study was the external validation of the updated logistic clinical SYNTAX score for two-year all-cause mortality after PCI in the GLOBAL LEADERS trial.METHODS AND RESULTS: The GLOBAL LEADERS trial was an investigator-initiated, prospective randomised, multicentre, open-label trial comparing two strategies of antiplatelet therapy in 15,991 patients undergoing PCI. As a predefined analysis, we studied the first 4,006 consecutive patients enrolled between July 2013 and April 2014 for whom the anatomic SYNTAX scores were calculated by an independent core lab. The updated logistic clinical SYNTAX score was available in 3,271 patients. Patients were divided into quintiles according to the score. The C-statistic of the updated logistic clinical SYNTAX score for two-year all-cause mortality was 0.71 (95% confidence interval [CI]: 0.64-0.77). The updated logistic clinical SYNTAX score identified patients at very high risk for two-year all-cause mortality after PCI. Although it systematically overestimated two-year all-cause mortality, predicted and observed two-year all-cause mortality in the majority of the patients (four out of five quintiles) were in agreement.CONCLUSIONS: Overall discrimination for two-year all-cause mortality of the updated logistic clinical SYNTAX score is either borderline acceptable or possibly helpful. Calibration in the majority of patients is appropriate. The score is potentially useful in selecting enriched high-risk populations.
AB - AIMS: The aim of this study was the external validation of the updated logistic clinical SYNTAX score for two-year all-cause mortality after PCI in the GLOBAL LEADERS trial.METHODS AND RESULTS: The GLOBAL LEADERS trial was an investigator-initiated, prospective randomised, multicentre, open-label trial comparing two strategies of antiplatelet therapy in 15,991 patients undergoing PCI. As a predefined analysis, we studied the first 4,006 consecutive patients enrolled between July 2013 and April 2014 for whom the anatomic SYNTAX scores were calculated by an independent core lab. The updated logistic clinical SYNTAX score was available in 3,271 patients. Patients were divided into quintiles according to the score. The C-statistic of the updated logistic clinical SYNTAX score for two-year all-cause mortality was 0.71 (95% confidence interval [CI]: 0.64-0.77). The updated logistic clinical SYNTAX score identified patients at very high risk for two-year all-cause mortality after PCI. Although it systematically overestimated two-year all-cause mortality, predicted and observed two-year all-cause mortality in the majority of the patients (four out of five quintiles) were in agreement.CONCLUSIONS: Overall discrimination for two-year all-cause mortality of the updated logistic clinical SYNTAX score is either borderline acceptable or possibly helpful. Calibration in the majority of patients is appropriate. The score is potentially useful in selecting enriched high-risk populations.
KW - Coronary Angiography
KW - Coronary Artery Disease
KW - Humans
KW - Percutaneous Coronary Intervention
KW - Platelet Aggregation Inhibitors
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Treatment Outcome
U2 - https://doi.org/10.4244/EIJ-D-19-00184
DO - https://doi.org/10.4244/EIJ-D-19-00184
M3 - Article
C2 - 31217143
SN - 1774-024X
VL - 15
SP - e539-e546
JO - Eurointervention
JF - Eurointervention
IS - 6
ER -