Development of a Risk Score for Long-term Survival and MACCE After Coronary Artery Bypass Grafting Surgery
Copyright © 2024. Published by Elsevier Inc..
OBJECTIVE: To develop risk scoring models predicting long-term survival and major adverse cardiovascular and cerebrovascular events (MACCE) including myocardial infarction and stroke after coronary artery bypass grafting (CABG).
METHODS: All-consecutive 4,821 patients undergoing isolated CABG at Lankenau between 01/2005-07/2021 were included. MACCE was defined as all-cause mortality+myocardial infarction (MI)+stroke. Variable selection for both outcomes was obtained using a double selection logit Lasso with adaptive selection. Models performance was internally evaluated by calibration and accuracy using bootstrap cross-validation. Mortality and MACCE were compared among patients split into three groups based on the predicted risk scores for all-cause mortality and MACCE. An external validation of our database was performed with 665 patients from the University of Brescia, Italy.
RESULTS: Pre-operative risk predictors were found to be predictors for all-cause mortality and MACCE. In addition, being of African American ethnicity is a significant predictor for MACCE after isolated CABG. The AUC which measures the discrimination of the models were 80.4%, 79.1%, 81.3%, and 79.2% for mortality at 1,2,3, and 5 years follow-up. The AUC for MACCE were 75%, 72.5%, 73,8%, and 72.7% at 1, 2, 3, and 5-years follow-up. For external validation, AUC for all-cause mortality and MACCE at 1, 2, 3, and 5 years was 73.7%, 70.8%, 68.7%, and 72.2% and 72.3%, 68.2%, 65.6%, 69.6%, respectively.
CONCLUSIONS: The Advanced (AD) Coronary Risk Score for All-Cause Mortality and MACCE provide good discrimination of long-term mortality and MACCE after isolated CABG. External validation observed a more AUC's above 70%.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
The American journal of cardiology - (2024) vom: 10. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dokollari, Aleksander [VerfasserIn] |
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Date Revised 12.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.amjcard.2024.03.039 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370981154 |
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| 100 | 1 | |a Dokollari, Aleksander |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Development of a Risk Score for Long-term Survival and MACCE After Coronary Artery Bypass Grafting Surgery |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 12.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024. Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVE: To develop risk scoring models predicting long-term survival and major adverse cardiovascular and cerebrovascular events (MACCE) including myocardial infarction and stroke after coronary artery bypass grafting (CABG) | ||
| 520 | |a METHODS: All-consecutive 4,821 patients undergoing isolated CABG at Lankenau between 01/2005-07/2021 were included. MACCE was defined as all-cause mortality+myocardial infarction (MI)+stroke. Variable selection for both outcomes was obtained using a double selection logit Lasso with adaptive selection. Models performance was internally evaluated by calibration and accuracy using bootstrap cross-validation. Mortality and MACCE were compared among patients split into three groups based on the predicted risk scores for all-cause mortality and MACCE. An external validation of our database was performed with 665 patients from the University of Brescia, Italy | ||
| 520 | |a RESULTS: Pre-operative risk predictors were found to be predictors for all-cause mortality and MACCE. In addition, being of African American ethnicity is a significant predictor for MACCE after isolated CABG. The AUC which measures the discrimination of the models were 80.4%, 79.1%, 81.3%, and 79.2% for mortality at 1,2,3, and 5 years follow-up. The AUC for MACCE were 75%, 72.5%, 73,8%, and 72.7% at 1, 2, 3, and 5-years follow-up. For external validation, AUC for all-cause mortality and MACCE at 1, 2, 3, and 5 years was 73.7%, 70.8%, 68.7%, and 72.2% and 72.3%, 68.2%, 65.6%, 69.6%, respectively | ||
| 520 | |a CONCLUSIONS: The Advanced (AD) Coronary Risk Score for All-Cause Mortality and MACCE provide good discrimination of long-term mortality and MACCE after isolated CABG. External validation observed a more AUC's above 70% | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Rosati, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Muneretto, Claudio |e verfasserin |4 aut | |
| 700 | 1 | |a Amabile, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Pernoci, Marjela |e verfasserin |4 aut | |
| 700 | 1 | |a Gemelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Hassanabad, Ali Fatehi |e verfasserin |4 aut | |
| 700 | 1 | |a Sicouri, Serge |e verfasserin |4 aut | |
| 700 | 1 | |a Sicouri, Noah |e verfasserin |4 aut | |
| 700 | 1 | |a Yamashita, Yoshiyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Baudo, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Bonacchi, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Cabrucci, Francesco |e verfasserin |4 aut | |
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| 700 | 1 | |a Shah, Ashish |e verfasserin |4 aut | |
| 700 | 1 | |a Coku, Lindita |e verfasserin |4 aut | |
| 700 | 1 | |a Cameli, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Mandoli, Giulia Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Kjelstrom, Stephanie |e verfasserin |4 aut | |
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| 700 | 1 | |a Ramlawi, Basel |e verfasserin |4 aut | |
| 700 | 1 | |a DiMagli, Arnaldo |e verfasserin |4 aut | |
| 700 | 1 | |a Sutter, Francis P |e verfasserin |4 aut | |
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