Validation of the Mayo Clinic Percutaneous Coronary Intervention Risk Prediction Score in Patients With Acute Coronary Syndrome
Year: 2025
Type: article
Abstract: BACKGROUND: A contemporary, comprehensive risk score for the prediction of in-hospital fatal and nonfatal adverse events after percutaneous coronary intervention has been recently developed, albeit its external validation in patients with acute coronary syndrome is lacking. The objective of this study is to validate the Mayo Clinic integer risk score in a large cohort of patients with acute coronary syndrome undergoing percutaneous coronary intervention from the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: The risk score is composed of a common set of 23 clinical and procedural variables (model A) and 18 preprocedural variables (model B). The primary objective was to appraise the receiver-operator characteristics of both models for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke. The impact of risk score categories on 1-year outcomes was also investigated. RESULTS: Among the 6724 patients undergoing percutaneous coronary intervention in the MATRIX trial, the receiver-operator characteristics-area under the curves for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke were 0.88 (95% CI, 0.85-0.91), 0.66 (95% CI, 0.63-0.69), 0.70 (95% CI, 0.67-0.72), and 0.65 (95% CI, 0.52-0.78) for model A and 0.88 (95% CI, 0.84-0.92), 0.63 (95% CI, 0.60-0.66), 0.66 (95% CI, 0.63-0.69), and 0.65 (95% CI, 0.52-0.78) for model B, respectively. Mortality (model A), bleeding, and stroke risks were well calibrated, whereas mortality (model B) and contrast-associated acute kidney injury risk were underestimated. There was a gradual risk increase for 1-year mortality and bleeding as a function of the risk score tertile using both models. CONCLUSIONS: The risk score identifies patients with acute coronary syndrome at incremental risk of in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke, representing a valuable tool for mitigation of modifiable risk factors. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01433627.
Institutions: Ente Ospedaliero Cantonale, Istituto Cardiocentro Ticino, Università della Svizzera italiana, Università Cattolica del Sacro Cuore, Mayo Clinic, University of Florida, University of Catania, Policlinico Universitario di Catania, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", New York University, Hôpital de la Tour, University of Bern
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,810
OpenAlex ID: W4414984832