title: Evaluation of algorithms for registry-based detection of acute myocardial infarction following percutaneous coronary intervention.
abstract: BACKGROUND
  Registry-based monitoring of the safety and efficacy of interventions in patients with ischemic heart disease requires validated algorithms.
  
  
  OBJECTIVE
  We aimed to evaluate algorithms to identify acute myocardial infarction (AMI) in the Danish National Patient Registry following percutaneous coronary intervention (PCI).
  
  
  METHODS
  Patients enrolled in clinical drug-eluting stent studies at the Department of Cardiology, Aarhus University Hospital, Denmark, from January 2006 to August 2012 were included. These patients were evaluated for ischemic events, including AMI, during follow-up using an end point committee adjudication of AMI as reference standard.
  
  
  RESULTS
  Of 5,719 included patients, 285 patients suffered AMI within a mean follow-up time of 3 years after stent implantation. An AMI discharge diagnosis (primary or secondary) from any acute or elective admission had a sensitivity of 95%, a specificity of 93%, and a positive predictive value of 42%. Restriction to acute admissions decreased the sensitivity to 94% but increased the specificity to 98% and the positive predictive value to 73%. Further restriction to include only AMI as primary diagnosis from acute admissions decreased the sensitivity further to 82%, but increased the specificity to 99% and the positive predictive value to 81%. Restriction to patients admitted to hospitals with a coronary angiography catheterization laboratory increased the positive predictive value to 87%.
  
  
  CONCLUSIONS
  Algorithms utilizing additional information from the Danish National Patient Registry yield different sensitivities, specificities, and predictive values in registry-based detection of AMI following PCI. We were able to identify AMI following PCI with moderate-to-high validity. However, the choice of algorithm will depend on the specific study purpose.
authors: Department of Cardiology; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus.
authors: Gro
authors: G
authors: Egholm
authors: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus.
authors: Morten
authors: M
authors: Madsen
authors: Department of Cardiology.
authors: Troels
authors: T
authors: Thim
authors: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Internal Medicine, Regional Hospital of Randers, Denmark.
authors: Morten
authors: M
authors: Schmidt
authors: Department of Cardiology.
authors: Evald Høj
authors: EH
authors: Christiansen
authors: Department of Cardiology.
authors: Hans Erik
authors: HE
authors: Bøtker
authors: Department of Cardiology.
authors: Michael
authors: M
authors: Maeng
keywords: Danish National Patient Registry; percutaneous coronary intervention; registry; sensitivity; specificity; validity