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Titolo:
Development and validation of a Bayesian index for predicting major adverse cardiac events with percutaneous transluminal coronary angioplasty
Autore:
de Belder, AJ; Jewitt, DE; Wainwright, RJ; Thomas, MR;
Indirizzi:
Kings Healthcare Trust, Dept Cardiol, London SE5 9RS, England Kings Healthcare Trust London England SE5 9RS l, London SE5 9RS, England Royal Sussex Cty Hosp, Dept Cardiol, Brighton BN2 5BE, E Sussex, England Royal Sussex Cty Hosp Brighton E Sussex England BN2 5BE E Sussex, England
Titolo Testata:
HEART
fascicolo: 1, volume: 85, anno: 2001,
pagine: 69 - 72
SICI:
1355-6037(200101)85:1<69:DAVOAB>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
COMPLICATIONS;
Keywords:
percutaneous transluminal coronary angioplasty; Bayesian risk; outcome prediction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
8
Recensione:
Indirizzi per estratti:
Indirizzo: Thomas, MR Kings Healthcare Trust, Dept Cardiol, Denmark Hill, London SE5 9RS, England Kings Healthcare Trust Denmark Hill London England SE5 9RS and
Citazione:
A.J. de Belder et al., "Development and validation of a Bayesian index for predicting major adverse cardiac events with percutaneous transluminal coronary angioplasty", HEART, 85(1), 2001, pp. 69-72

Abstract

Objective-To create a risk model for predicting major adverse complicatingevents of percutaneous transluminal coronary angioplasty (PTCA), and to test the accuracy of the model on a prospective cohort of patientsSetting-Tertiary cardiac centreMethods-Available software can predict probabilities of events using Bayes's theorem. To establish the accuracy of these predictive tools, a Bayes table was created to evaluate major adverse complicating events (MACE)-death,emergency coronary artery bypass grafting (CABG), or Q wave infarct occurring during the in-patient episode-on the first 1500 patients in the department PTCA database (development group); the predictive value of this model was then tested with the subsequent 1000 patients (evaluation group). The following probabilities were assessed to determine their association with MACE: age, sex, left ventricular function, American Heart Association lesion morphology classification, cardiogenic shock, previous CABG, diabetes, hypertension, multivessel PTCA. Main outcome measures-To establish the discriminatory ability of the predictive index, calibration plots and receiver operating characteristic (ROC) curves were obtained to compare the development and evaluation groups. Results-The ROC curve plotted to determine the discriminatory value of theBayesian table created from the development group (n = 1500) in predictingMACE in the evaluation group (n = 1000) showed a moderately predictive area under the curve of 0.76 (SEM 0.07). This predictive accuracy was confirmed with separately constructed calibration plots. Conclusions-Accurate predictions of MACE can be identified in populations undergoing percutaneous intervention. The database used allows operators toobtain consent from patients appropriately from their own experience rather than from other published data. If a national PTCA database existed alongsimilar lines, individual operators and interventional centres could compare themselves with nationally available data.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/20 alle ore 20:55:26