Validation of EuroSCORE II, ACEF Score, CHA[sub.2]DS[sub.2]-VASc, and CHA[sub.2]DS[sub.2]-VA in Patients Undergoing Left Main Coronary Artery Angioplasty: Analysis from All-Comers BIA-LM Registry

• Published in: Journal of clinical medicine 2024-11, Vol.13 (22)
• Main Authors: D'browski, Emil Julian, Kralisz, Pawel, Nowak, Konrad, Gugala, Kamil, Prokopczuk, Przemyslaw, Mezynski, Grzegorz, Swieczkowski, Michal, Dobrzycki, Slawomir, Kozuch, Marcin
• Format: Article
• Language: English
• Subjects: Care and treatment; Coronary heart disease; Mortality; Prognosis; Transluminal angioplasty
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13226907

Background : Simple surgical and clinical risk scores are useful in mortality prediction. Aims : The study’s aim was to validate three scores in real-world registry of percutaneous coronary intervention (PCI) for the left main coronary artery (LMCA). Methods : All data were obtained from the BIA-LM Registry. Discrimination and calibration of EuroSCORE II, ACEF, CHA[sub.2] DS[sub.2] -VASc, and CHA[sub.2] DS[sub.2] -VA were assessed with receiver operating characteristic (ROC) curves analysis and Hosmer–Lemeshow (HL) test. Results : The final cohort included 851 patients, median age was 71, and 156 patients had history of previous coronary artery bypass grafting (CABG). Median EuroSCORE II, ACEF, CHA[sub.2] DS[sub.2] -VASc, and CHA[sub.2] DS[sub.2] -VA were 3.1% (IQR 5.4%), 1.56 (IQR 0.9), 4 (IQR 2), and 4 (IQR 2), respectively. In the short- (30 days) and long-term (mean 4.1 years), there were 27 and 318 deaths. In short-term, EuroSCORE II showed the best discrimination in the overall population and subgroup with unprotected LMCA [area under the curve (AUC) 0.804, 95% CI 0.717–0.890 and AUC 0.826, 95% CI 0.737–0.913, respectively, p < 0.001 for comparisons with other models), with the best cut-off value at 7.1%. In long-term observation, EuroSCORE II and ACEF showed good predictive value (overall population: AUC 0.716, 95% CI 0.680–0.750 and AUC 0.725, 95% CI 0.690–760, respectively). In short- and long-term observation, EuroSCORE II and ACEF showed poor calibration (HL test p < 0.05) as compared to CHA[sub.2] DS[sub.2] -VASc (HL test p = 0.40 and 0.18). Conclusions : EuroSCORE II showed good mortality prediction in short-term observation; however, its predicted risk should be interpreted with caution due to poor calibration. ACEF and EuroSCORE II may be useful in long-term mortality prediction.