Validation of UK-BCIS CHIP Score to Predict 1-Year Outcomes in a Contemporary United States Population

Gaurav Khandelwal, Alessandro Spirito, Richard Tanner, Anoop N. Koshy, Samantha Sartori, Negar Salehi, Gennaro Giustino, Vishal Dhulipala, Zhongjie Zhang, Jaime Gonzalez, Amit Hooda, Manish Vinayak, Asif Shaikh, Roxana Mehran, Annapoorna S. Kini, Samin K. Sharma

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and their risk of in-hospital major adverse cardiac or cerebrovascular events (MACCE). Objectives: The authors sought to apply this score to a contemporary U.S. population for the prediction of adverse events at 1 year following percutaneous coronary intervention (PCI). Methods: Consecutive patients undergoing PCI at a large tertiary care center between 2011 and 2020 were considered for inclusion. Patients were categorized into 4 groups based on their BCIS-CHIP score (0, 1-2, 3-4, ≥5). In each category, we assessed the 1-year risk of MACCE, a composite of all-cause death, myocardial infarction, and stroke. Secondary outcomes were the individual components of MACCE, and major bleeding at 1 year. Results: Among 20,799 patients included, MACCE at 1 year occurred in 1.7% patients with score 0 (reference), 3.0% with score 1 or 2 (HR: 1.72; 95% CI: 1.32-2.24), 6.1% with score 3 or 4 (HR: 3.60; 95% CI: 2.78-4.66), and 12.0% with score ≥5 (HR: 7.40; 95% CI: 5.75-9.51). Each point increase of the BCIS-CHIP score conferred a 28.0% increase of MACCE risk. The BCIS-CHIP score demonstrated good discrimination for the prediction of 1-year MACCE (C-index 0.70). The risk of secondary outcomes also progressively increased with higher score values. Conclusions: In a large PCI registry, the BCIS-CHIP score had a good predictive value for MACCE at 1 year. The utilization of this score can facilitate an accurate risk stratification of patients undergoing PCI.

Original languageEnglish
Pages (from-to)1011-1020
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume16
Issue number9
DOIs
StatePublished - 8 May 2023

Keywords

  • complex percutaneous coronary intervention
  • outcomes
  • risk stratification
  • score

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