Validation of UK-BCIS CHIP Score to Predict 1-Year Outcomes in a Contemporary United States Population

• Published in: JACC. Cardiovascular interventions 2023-05, Vol.16 (9), p.1011-1020
• Main Authors: Khandelwal, Gaurav, Spirito, Alessandro, Tanner, Richard, Koshy, Anoop N., Sartori, Samantha, Salehi, Negar, Giustino, Gennaro, Dhulipala, Vishal, Zhang, Zhongjie, Gonzalez, Jaime, Hooda, Amit, Vinayak, Manish, Shaikh, Asif, Mehran, Roxana, Kini, Annapoorna S., Sharma, Samin K.
• Format: Article
• Language: English
• Subjects: complex percutaneous coronary intervention; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary Artery Disease - therapy; Humans; Myocardial Infarction - etiology; outcomes; Percutaneous Coronary Intervention - adverse effects; risk stratification; score; Treatment Outcome; United Kingdom
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2023.02.005

A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and their risk of in-hospital major adverse cardiac or cerebrovascular events (MACCE). The authors sought to apply this score to a contemporary U.S. population for the prediction of adverse events at 1 year following percutaneous coronary intervention (PCI). Consecutive patients undergoing PCI at a large tertiary care center between 2011 and 2020 were considered for inclusion. Patients were categorized into 4 groups based on their BCIS-CHIP score (0, 1-2, 3-4, ≥5). In each category, we assessed the 1-year risk of MACCE, a composite of all-cause death, myocardial infarction, and stroke. Secondary outcomes were the individual components of MACCE, and major bleeding at 1 year. Among 20,799 patients included, MACCE at 1 year occurred in 1.7% patients with score 0 (reference), 3.0% with score 1 or 2 (HR: 1.72; 95% CI: 1.32-2.24), 6.1% with score 3 or 4 (HR: 3.60; 95% CI: 2.78-4.66), and 12.0% with score ≥5 (HR: 7.40; 95% CI: 5.75-9.51). Each point increase of the BCIS-CHIP score conferred a 28.0% increase of MACCE risk. The BCIS-CHIP score demonstrated good discrimination for the prediction of 1-year MACCE (C-index 0.70). The risk of secondary outcomes also progressively increased with higher score values. In a large PCI registry, the BCIS-CHIP score had a good predictive value for MACCE at 1 year. The utilization of this score can facilitate an accurate risk stratification of patients undergoing PCI. [Display omitted]