Development and validation of a nomogram predicting one-year mortality in patients undergoing percutaneous coronary intervention.

Abstract

To formulate a nomogram to predict the risk of one-year mortality after percutaneous coronary intervention (PCI) based on a large-scale real-world Asian cohort. This study cohort included consecutive patients undergoing PCI in the National Center for Cardiovascular Diseases of China. The endpoint was all-cause mortality. Least absolute shrinkage and selection operator Cox regression and backward stepwise regression were used to select potential risk factors. A nomogram based on the predictors was accordingly constructed to predict one-year mortality. The performance of the nomogram was evaluated. Patients were stratified into low-, intermediate- and high-risk groups according to the tertile points in the nomogram and compared by the Kaplan-Meier analysis. A total of 9603 individuals were included in this study and randomly divided into the derivation cohort (60%) and the validation cohort (40%). Six variables were selected to formulate the nomogram, including age, renal insufficiency, cardiac dysfunction, previous cerebrovascular disease, previous PCI, and TIMI 0-1 before PCI. The area under the curve of this nomogram regarding one-year mortality risks were 0.792 and 0.754 in the derivation cohort and validation cohort, respectively. Kaplan-Meier curve successfully stratified the patients according to three risk groups. This nomogram calibrated well and exhibited satisfactory clinical utility in the decision curve analysis. This study developed and validated a simple-to-use nomogram predicting one-year mortality risk in Asian patients undergoing PCI and could help clinicians make risk-dependent decisions.