title: Prediction of long-term mortality after percutaneous coronary intervention in older adults: results from the National Cardiovascular Data Registry.
abstract: BACKGROUND
  The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infarction and those with more stable coronary disease.
  
  
  RESULTS
  The American College of Cardiology Foundation CathPCI Registry data were linked to the Centers for Medicare and Medicaid Services 100% denominator file by probabilistic matching. Preprocedure demographic and clinical variables from the CathPCI Registry were used to predict the probability of death over 3 years as recorded in the Centers for Medicare and Medicaid Services database. Between 2004 and 2007, 343 466 patients (66%) of 518 195 patients aged ≥65 years undergoing first percutaneous coronary intervention in the CathPCI Registry were successfully linked to Centers for Medicare and Medicaid Services data. This study population was randomly divided into 60% derivation and 40% validation cohorts. Median follow-up was 15 months, with mortality of 3.0% at 30 days and 8.7%, 13.4%, and 18.7% at 1, 2, and 3 years, respectively. Twenty-four characteristics related to demographics, clinical comorbidity, prior history of disease, and indices of disease severity and acuity were identified as being associated with mortality. The C indices in the validation cohorts for patients with and without ST-segment elevation myocardial infarction were 0.79 and 0.78. The model calibrated well across a wide range of predicted probabilities.
  
  
  CONCLUSIONS
  On the basis of the large and nationally representative CathPCI Registry, we have developed a model that has excellent discrimination, calibration, and validation to predict survival up to 3 years after percutaneous coronary intervention.
authors.affiliation: Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718, USA. wweintraub@christianacare.org
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
authors.forename: Maria V
authors.initials: MV
authors.lastname: Grau-Sepulveda
authors.forename: Jocelyn M
authors.initials: JM
authors.lastname: Weiss
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Delong
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: Sean M
authors.initials: SM
authors.lastname: O'Brien
authors.forename: Paul
authors.initials: P
authors.lastname: Kolm
authors.forename: Lloyd W
authors.initials: LW
authors.lastname: Klein
authors.forename: Richard E
authors.initials: RE
authors.lastname: Shaw
authors.forename: Charles
authors.initials: C
authors.lastname: McKay
authors.forename: Laura L
authors.initials: LL
authors.lastname: Ritzenthaler
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Popma
authors.forename: John C
authors.initials: JC
authors.lastname: Messenger
authors.forename: David M
authors.initials: DM
authors.lastname: Shahian
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Grover
authors.forename: John E
authors.initials: JE
authors.lastname: Mayer
authors.forename: Kirk N
authors.initials: KN
authors.lastname: Garratt
authors.forename: Issam D
authors.initials: ID
authors.lastname: Moussa
authors.forename: Fred H
authors.initials: FH
authors.lastname: Edwards
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality* / Q000639:trends*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D011237:Predictive Value of Tests; D012042:Registries; D015996:Survival Rate / Q000639:trends*; D013997:Time Factors; D014481:United States / Q000453:epidemiology