Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases Beijing China.
Coronary Heart Disease Center, Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases Beijing China.
J Am Heart Assoc. 2023 Apr 4;12(7):e025812. doi: 10.1161/JAHA.122.025812. Epub 2023 Mar 28.
Background The PRAISE (Prediction of Adverse Events Following an Acute Coronary Syndrome) score is a machine-learning-based model for predicting 1-year all-cause death, myocardial infarction, and Bleeding Academic Research Consortium (BARC) type 3/5 bleeding. Its utility in an unselected Asian population undergoing percutaneous coronary intervention for acute coronary syndrome remains unknown. We aimed to validate the PRAISE score in a real-world Asian population. Methods and Results A total of 6412 consecutive patients undergoing percutaneous coronary intervention for acute coronary syndrome were prospectively included. The PRAISE scores were compared with established scoring systems (GRACE [Global Registry of Acute Coronary Events] 2.0, PRECISE-DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy), and PARIS [Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients]) to evaluate their discrimination, calibration, and reclassification. The risk of all-cause mortality (hazard ratio [HR], 12.24 [95% CI, 5.32-28.15]) and recurrent acute myocardial infarction (HR, 3.92 [95% CI, 1.76-8.73]) was greater in the high-risk group than in the low-risk group. The C-statistics for death, myocardial infarction, and major bleeding were 0.75 (0.67-0.83), 0.61 (0.52-0.69), and 0.62 (0.46-0.77), respectively. The observed to expected ratio of death, myocardial infarction, and major bleeding was 0.427, 0.260, and 0.106, respectively. Based on the decision curve analysis, the PRAISE score displayed a slightly greater net benefit for the 1-year risk of death (5%-10%) than the GRACE score did. Conclusions The PRAISE score showed limited potential for risk prediction in our validation cohort with acute coronary syndrome. As a result, new prediction models or model refitting are required with improved discrimination and accuracy in risk prediction.
PRAISE（急性冠状动脉综合征后不良事件预测）评分是一种基于机器学习的模型，用于预测 1 年全因死亡、心肌梗死和 Bleeding Academic Research Consortium（BARC）3/5 级出血。其在接受经皮冠状动脉介入治疗的急性冠状动脉综合征的未经选择的亚洲人群中的应用尚不清楚。我们旨在验证 PRAISE 评分在真实亚洲人群中的适用性。
共前瞻性纳入 6412 例接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者。将 PRAISE 评分与已建立的评分系统（GRACE[全球急性冠状动脉事件注册]2.0、PRECISE-DAPT[预测接受支架植入和随后双联抗血小板治疗患者出血并发症]和 PARIS[支架置入患者抗血小板治疗方案不依从模式]）进行比较，以评估其区分度、校准度和重新分类能力。高危组的全因死亡率（危险比[HR]，12.24[95%CI，5.32-28.15]）和复发性急性心肌梗死（HR，3.92[95%CI，1.76-8.73]）风险均高于低危组。死亡、心肌梗死和主要出血的 C 统计量分别为 0.75（0.67-0.83）、0.61（0.52-0.69）和 0.62（0.46-0.77）。死亡、心肌梗死和主要出血的观察到的与预期的比值分别为 0.427、0.260 和 0.106。基于决策曲线分析，PRAISE 评分在预测 1 年死亡风险（5%-10%）方面的净获益略高于 GRACE 评分。
PRAISE 评分在我们的急性冠状动脉综合征验证队列中对风险预测的潜力有限。因此，需要新的预测模型或模型重新拟合，以提高区分度和风险预测的准确性。
Zotero 插件
