Thromb Haemost 2021; 121(03): 297-308
DOI: 10.1055/s-0040-1718411
Coagulation and Fibrinolysis

A Novel ABC Score Predicts Mortality in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Who underwent Percutaneous Coronary Intervention

Ying-Ying Zheng*
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Ting-Ting Wu*
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Ying Gao*
4  Cadre Ward, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Qian-Qian Guo
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Yan-Yan Ma
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Jian-Chao Zhang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Yi-Li Xun
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Ding-Yu Wang
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Ying Pan
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Meng-Die Cheng
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Feng-Hua Song
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Zhi-Yu Liu
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Kai Wang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Li-Zhu Jiang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Lei Fan
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Xiao-Ting Yue
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Yan Bai
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Zeng-Lei Zhang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Xin-Ya Dai
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Ru-Jie Zheng
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
You Chen
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Xiang Ma
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Yi-Tong Ma
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Jin-Ying Zhang
1  Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
2  Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
,
Xiang Xie
3  Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
› Author Affiliations
Funding This research was funded by Xinjiang Science and Technology Aid Project (2019E0278), Tianshan Xuesong Project (2018XS17), China Postdoctoral Foundation (2019M652593) and Postdoctoral Research Grant Foundation in Henan Province (1902006).

Abstract

Objective In the present study, we aimed to establish a novel score to predict long-term mortality of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients who underwent percutaneous coronary intervention (PCI).

Methods A total of 2,174 NSTE-ACS patients from the CORFCHD-ZZ study were enrolled as the derivation cohort. The validation cohort including 1,808 NSTE-ACS patients were from the CORFCHD-PCI study. Receiver operating characteristic analysis and area under the curve (AUC) evaluation were used to select the candidate variables. The model performance was validated internally and externally. The primary outcome was cardiac mortality (CM). We also explored the model performance for all-cause mortality (ACM).

Results Initially, 28 risk factors were selected and ranked according to their AUC values. Finally, we selected age, N-terminal pro-B-type natriuretic peptide, and creatinine to develop a novel prediction model named “ABC” model. The ABC model had a high discriminatory ability for both CM (C-index: 0.774, p < 0.001) and ACM (C-index: 0.758, p < 0.001) in the derivation cohort. In the validation cohort, the C-index of CM was 0.802 (p < 0.001) and that of ACM was 0.797 (p < 0.001), which suggested good discrimination. In addition, this model had adequate calibration in both the derivation and validation cohorts. Furthermore, the ABC score outperformed the GRACE score to predict mortality in NSTE-ACS patients who underwent PCI.

Conclusion In the present study, we developed and validated a novel model to predict mortality in patients with NSTE-ACS who underwent PCI. This model can be used as a credible tool for risk assessment and management of NSTE-ACS after PCI.

* These authors contributed equally to this work.


Supplementary Material



Publication History

Received: 20 July 2020

Accepted: 31 August 2020

Publication Date:
31 October 2020 (online)

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