OR36. External validation of in-hospital major adverse cardiovascular events’ predictor in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

Aims KARIADI risk score is a 0-to-9 point scoring system based on Killip class, final TIMI flow, total ischemic time, creatinine level, blood glucose, systolic blood pressure, and age. This score was developed to predict the risk of in-hospital major adverse cardiovascular events (MACE) (composite of death, stroke, urgent revascularization, cardiogenic shock, acute pulmonary edema, or arrhythmia) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI). KARIADI risk score was claimed to be able to predict MACE with a rate of 1.2% at lowest score until 99.9% at highest score, but its performance has never been validated externally. This study aims to perform external validation on KARIADI risk score. Methods and Results This study was a prospective cohort study on 109 STEMI patients undergoing PPCI in Dr. Kariadi General Hospital during January-November 2020. Each sample underwent KARIADI risk score assessment and follow-up for in-hospital MACE. The risk score validation was performed by assessing calibration [measured with calibration-in-the-large (alpha), calibration slope (beta), and calibration plot] and discrimination performance [measured with c-statistic and receiver operating characteristic (ROC) curve). Eighteen patients (16.5%) had MACE. The calibration plot of KARIADI risk score demonstrated moderate calibration with alpha -0.39, beta 0.71, and reasonably close calibration to line of identity; meanwhile the ROC curve demonstrated moderate discrimination with c-statistic 0.75, 95% CI 0.62-0.87. Conclusion KARIADI risk score has moderate external validation in predicting in-hospital MACE in patients with STEMI undergoing PPCI.