Abstract 11233: Independent Validation of the Canada-Percutaneous Coronary Intervention Risk Score Using Singapore Cardiac Data Bank Registry
Background: The Canada-Percutaneous Coronary Intervention(PCI) risk score is a robust validated model of 30-day mortality after PCI developed from the British Columbia Cardiac Registry(BCCR). Validation has not been performed in Asian countries. The Singapore Cardiac Data Bank(SCDB) has comprehensive archived data similar to BCCR on PCI patients in major centres. The aim of this study is to validate the Canada-PCI score using a large multiethnic Asian cohort.
Methods: We analyzed prospectively collected data on 8992 consecutive patients undergoing native vessel PCI from 1 Jan 2007 to 31 Dec 2009 in Singapore. We calculated the Canada-PCI score for each case using original BCPCI regression coefficients and intercepts. The discrimination of the BCPCI algorithm was assessed using the c statistic derived from the Receiver-operating curve. The Hosmer-Lemeshow χ2(HL) statistic was used to assess the ability of the model to determine the absolute 30-day mortality risk. Multivariate analysis was further performed to identify risk factors for 30-day mortality.
Results: The cohort included 66.9% Chinese, 15.9% Malay and 13.3% Asiatic Indian subjects. 79.9% were males, 19.8% presented with STEMI, and 14.6% had tripple vessel disease. Out of 8992 cases, death occurred in 2.4%. In the discriminatory analysis, the AUC was 0.90 showing excellent ability to distinguish deaths from non-deaths. In the calibration, HL was 8.43(p=0.392), showing the actual 30-day mortality rate in the SCDB cohort was similar to the event rate predicted by the Canada-PCI algorithm. Multivariate logistic regression analysis identified risk factors for 30-day mortality that were similar to the BCCR database risk factors.
Conclusions: This independent evaluation confirms the Canada-PCI score accurately predicts 30-day post PCI mortality in a large multiethnic Asian cohort. This first external validation of the Canada-PCI score supports its broader application to Asian populations.
- © 2011 by American Heart Association, Inc.