Prediction of long-term mortality after percutaneous coronary intervention in older adults: Results from the national cardiovascular data registry

William S. Weintraub, Maria V. Grau-Sepulveda, Jocelyn M. Weiss, Elizabeth R. Delong, Eric D. Peterson, Sean M. O'Brien, Paul Kolm, Lloyd W. Klein, Richard E. Shaw, Charles McKay, Laura L. Ritzenthaler, Jeffrey J. Popma, John C. Messenger, David M. Shahian, Frederick L. Grover, John E. Mayer, Kirk N. Garratt, Issam D. Moussa, Fred H. Edwards, George D. Dangas

Research output: Contribution to journalArticlepeer-review

77 Scopus citations

Abstract

Background-The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease. Methods and Results-The American College of Cardiology Foundation CathPCI Registry data were linked to the Centers for Medicare and Medicaid Services 100% denominator file by probabilistic matching. Preprocedure demographic and clinical variables from the CathPCI Registry were used to predict the probability of death over 3 years as recorded in the Centers for Medicare and Medicaid Services database. Between 2004 and 2007, 343 466 patients (66%) of 518 195 patients aged ≥65 years undergoing first percutaneous coronary intervention in the CathPCI Registry were successfully linked to Centers for Medicare and Medicaid Services data. This study population was randomly divided into 60% derivation and 40% validation cohorts. Median follow-up was 15 months, with mortality of 3.0% at 30 days and 8.7%, 13.4%, and 18.7% at 1, 2, and 3 years, respectively. Twenty-four characteristics related to demographics, clinical comorbidity, prior history of disease, and indices of disease severity and acuity were identified as being associated with mortality. The C indices in the validation cohorts for patients with and without ST-segment elevation myocardial infarction were 0.79 and 0.78. The model calibrated well across a wide range of predicted probabilities. Conclusions-On the basis of the large and nationally representative CathPCI Registry, we have developed a model that has excellent discrimination, calibration, and validation to predict survival up to 3 years after percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)1501-1510
Number of pages10
JournalCirculation
Volume125
Issue number12
DOIs
StatePublished - Mar 27 2012
Externally publishedYes

Keywords

  • coronary artery disease
  • mortality
  • percutaneous coronary intervention
  • registries
  • revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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