External Validation of the ACUITY/HORIZON Bleeding Risk Score among Acute Coronary Syndrome Patients in Thai PCI Registry
Issued Date
2023-02-07
Resource Type
ISSN
03406245
Scopus ID
2-s2.0-85142309738
Pubmed ID
36265499
Journal Title
Thrombosis and Haemostasis
Volume
123
Issue
2
Start Page
255
End Page
266
Rights Holder(s)
SCOPUS
Bibliographic Citation
Thrombosis and Haemostasis Vol.123 No.2 (2023) , 255-266
Suggested Citation
Roongsangmanoon W., Chichareon P., Angkananard T., Suwannasom P., Chandavimol M., Limpijankit T., Srimahachota S., Athisakul S., Hutayanon P., Kiatchoosakun S., Thanakitcharu P., Charoenpanichsunti M., Chamsaard P., Siriyotha S., Thakkinstian A., Sansanayudh N. External Validation of the ACUITY/HORIZON Bleeding Risk Score among Acute Coronary Syndrome Patients in Thai PCI Registry. Thrombosis and Haemostasis Vol.123 No.2 (2023) , 255-266. 266. doi:10.1055/a-1964-8247 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82399
Title
External Validation of the ACUITY/HORIZON Bleeding Risk Score among Acute Coronary Syndrome Patients in Thai PCI Registry
Author's Affiliation
Ramathibodi Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkia University
Bhumibol Adulyadej Hospital
King Chulalongkorn Memorial Hospital
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Srinakharinwirot University
University of Ubon Ratchathani
Phyathai Sriracha Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkia University
Bhumibol Adulyadej Hospital
King Chulalongkorn Memorial Hospital
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Srinakharinwirot University
University of Ubon Ratchathani
Phyathai Sriracha Hospital
Other Contributor(s)
Abstract
Background External validation is essential before implementing a predictive model in clinical practice. This analysis validated the performance of the ACUITY/HORIZON risk score in the most contemporary Thai PCI registry. Methods The ACUITY/HORIZON model was applied and validated externally in 12,268 ACS (acute coronary syndrome) patients. For revision and updating models, the regression coefficientd of all predictors were re-estimated and then additional predictors were stepwise selected from multivariate analysis. Results In-hospital bleeding defined by the BARC (Bleeding Academic Research Consortium) criteria was 1.3% (161 patients) and 2.3% (285 patients) by the ACUITY criteria. The calibration of both scales demonstrated overestimation of the original model with C-statistic values of 0.704 for ACUITY major bleeding and 0.793 for BARC 3 or 5 bleeding. For ACUITY major bleeding, the discriminatory power of the update model improved substantially when congestive heart failure (CHF), prior vascular disease as well as body mass index were considered. The update model demonstrated good calibration and C-statistic of 0.747 and 0.745 with no white blood cell (WBC) count. For BARC 3 or 5 bleeding, good calibration and discriminatory capacity could be observed when CHF and prior vascular disease were added in the update models, with an excellent C-statistic of 0.838, and a lower C-statistic value of 0.835 was obtained in the absence of WBC count.