Predicting Mortality After Percutaneous Coronary Intervention in a Multiethnic Southeast Asian Population: Insights From Machine Learning

Le résumé fourni par la source

Ischemic heart disease remains a major contributor to mortality in Malaysia, with non-elective percutaneous coronary intervention (PCI) frequently performed in high-risk acute coronary syndrome (ACS) patients. Using nationwide registry data (2007-2020), we evaluated 29,521 patients and compared seven machine learning (ML) models for predicting in-hospital, 30-day, and 1-year mortality. Models were developed in a training cohort and externally validated using hospital-level (TEST1) and prospective temporal (TEST2) cohorts. After logistic recalibration, discrimination for in-hospital mortality ranged from 0.927 to 0.943 (TEST1) and 0.865-0.884 (TEST2). For 30-day mortality, ROC-AUC ranged from 0.902 to 0.923 (TEST1) and 0.753-0.838 (TEST2), and for 1-year mortality from 0.833 to 0.859 (TEST1) and 0.750-0.801 (TEST2). Calibration remained acceptable, and decision curve analysis demonstrated positive net benefit across clinically relevant thresholds. Cross-model stability analysis consistently identified age, haemodynamic status, and renal function as key predictors.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.