Article Sidebar

PDF
Date Published: 30/01/2025
Online Published: 17/01/2025
Abstract Views: 17
Views PDF: 1
DOI: https://doi.org/10.47972/vjcts.v49i.1252
Issue
Vol. 49
Section
Research Article
How to Cite
Nguyen, T. M., Nguyen, S. H., Nguyen, T. P. L., Ta, D. T., Nguyen, T. T., & Doan, Q. H. (2025). Validation of Euroscore II in predicting early mortality of coronary artery bypass grafting surgery in patients with non-st elevation myocardial infarction. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 49, 79-91. https://doi.org/10.47972/vjcts.v49i.1252

Validation of Euroscore II in predicting early mortality of coronary artery bypass grafting surgery in patients with non-st elevation myocardial infarction

Thai Minh Nguyen1,2, Sinh Hien Nguyen1,2, Thanh Phi Long Nguyen, Dinh Trung Ta, Trong Tan Nguyen, Quoc Hung Doan1,3,
1 Hanoi Medical University
2 Hanoi Heart Hospital
3 Vinmec International Hospital

Main Article Content

Abstract

Abstract: Objectives: Our study aimed to determine EuroSCORE II’s performance in patients with non-ST-segment-elevation acute myocardial infarction undergoing coronary artery bypass grafting (CABG). Methods: A retrospective study of 307 patients with non-ST-elevation acute myocardial infarction undergoing CABG at Hanoi Heart Hospital (Hanoi, Vietnam) from January 1, 2020 to December 31, 2022. Patients were divided by the urgency of operation (emergency and non-emergency) and surgical risk (low: EuroSCORE < 2%, intermediate: 2 - 5%, high: > 5%). Discrimination accuracy was determined by the area under the receiver operating characteristic curve (AUC) and calibration by the observed/estimated (O/E) ratio. Hosmer-Lemeshow tests examined the correlation between EuroSCORE II and mortality in 30 days. Results: AUC and O/E ratio were 0,8117 (CI 95%: 0,67 - 0,95) and 0,85 overall. Regarding urgency of operation, discriminative accuracy and O/E ratio were effective in emergency patients [AUC: 0,8681 (0,67 - 1,00) and O/E 0,96] but were not effective in non-emergency patients [AUC: 0,6665 (0,51 - 0,82) and O/E 0,64]. Regarding surgical risk, AUC and O/E ratio were 0,9316 (0,86 - 1,00) and 1,13 in low-risk patients; 0,5118 (0,06 - 0,97) and 0,94 in intermediate-risk patients; 0,9552 (0,91 - 1,00) and 0,78 in high-risk patients. Conclusions: EuroSCORE II is an effective and accurate tool for estimating the surgical risk of patients undergoing CABG in non-ST-segment-elevation myocardial infarction, especially in emergency and high-risk patients.

Article Details

Keywords

CABG, NSTEMI, EuroSCORE II, mortality

References

1. Khera S, Kolte D, Aronow WS, Palaniswamy C, Subramanian KS, Hashim T, et al. Non‐ST‐Elevation Myocardial Infarction in the United States: Contemporary Trends in Incidence, Utilization of the Early Invasive Strategy, and In‐Hospital Outcomes. Journal of the American Heart Association. 2014 Aug 15;3(4):e000995.
2. Omerovic E, Råmunddal T, Petursson P, Angerås O, Rawshani A, Jha S, et al. Percutaneous vs. surgical revascularization of non-ST-segment elevation myocardial infarction with multivessel disease: the SWEDEHEART registry. Eur Heart J. 2024 Nov 27;ehae700.
3. Billah B, Huq MM, Smith JA, Sufi F, Tran L, Shardey GC, et al. AusSCORE II in predicting 30-day mortality after isolated coronary artery bypass grafting in Australia and New Zealand. The Journal of Thoracic and Cardiovascular Surgery. 2014 Nov 1;148(5):1850-1855.e2.
4. Luo H. Risk-Predictive Models for Adverse Events in Cardiac Surgery: A Review. Cardiovascular Innovations and Applications. 2024 Jan 5;9:997.
5. Mastroiacovo G, Bonomi A, Ludergnani M, Franchi M, Maragna R, Pirola S, et al. Is EuroSCORE II still a reliable predictor for cardiac surgery mortality in 2022? A retrospective study study. Eur J Cardiothorac Surg. 2023 Sep 5;64(3):ezad294.
6. Shan L, Ge W, Pu Y, Cheng H, Cang Z, Zhang X, et al. Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system. PeerJ. 2018 Feb 23;6:e4413.
7. Định DN, Trí HHQ. Nghiên cứu ứng dụng thang điểm Euroscore ii trong tiên lượng tử vong sớm trên bệnh nhân phẫu thuật bắc cầu chủ vành. TC Tim mạch học VN. 2014 Nov 1;(68):64–71.
8. Quang THH, Dương LP, Hùng DV, Thanh BP. Outcome of patients with acute myocardial infarction undergoing coronary artery bypass grafting. VJCTS. 2023 Jan 18;40:69–74.
9. Polo TCF, Miot HA. Use of ROC curves in clinical and experimental studies. J Vasc Bras. 19:e20200186.
10. Nashef SAM, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012 Apr;41(4):734–44; discussion 744-745.
11. Biancari F, Vasques F, Mikkola R, Martin M, Lahtinen J, Heikkinen J. Validation of EuroSCORE II in patients undergoing coronary artery bypass surgery. Ann Thorac Surg. 2012 Jun;93(6):1930–5.
12. Guillet L, Moury PH, Bedague D, Durand M, Martin C, Payen JF, et al. Comparison of the additive, logistic european system for cardiac operative risk (EuroSCORE) with the EuroSCORE 2 to predict mortality in high-risk cardiac surgery. Ann Card Anaesth. 2020;23(3):277–82.
13. Shales S, Uma Maheswara Rao S, Khapli S, Ghorai PA, Behera SK, Ghosh AK, et al. Comparison of European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the Society of Thoracic Surgeons(STS) score for risk prediction in Indian patients undergoing coronary artery bypass grafting. Indian J Thorac Cardiovasc Surg. 2021 Nov;37(6):623–30.
14. Musa AF, Cheong XP, Dillon J, Nordin RB. Validation of EuroSCORE II in patients undergoing coronary artery bypass grafting (CABG) surgery at the National Heart Institute, Kuala Lumpur: a retrospective review. F1000Res. 2018;7:534.
15. Kurniawaty J, Setianto BY, Widyastuti Y, Supomo S, Boom CE, Ancilla C. Validation for EuroSCORE II in the Indonesian cardiac surgical population: a retrospective, multicenter study. Expert Rev Cardiovasc Ther. 2022 Jun;20(6):491–6.
16. Grant SW, Hickey GL, Dimarakis I, Cooper G, Jenkins DP, Uppal R, et al. Performance of the EuroSCORE models in emergency cardiac surgery. Circ Cardiovasc Qual Outcomes. 2013 Mar 1;6(2):178–85.
17. Axelsson TA, Mennander A, Malmberg M, Gunn J, Jeppsson A, Gudbjartsson T. Is emergency and salvage coronary artery bypass grafting justified? The Nordic Emergency/Salvage coronary artery bypass grafting study. Eur J Cardiothorac Surg. 2016 May;49(5):1451–6.
18. Biancari F, Onorati F, Rubino AS, Mosorin MA, Juvonen T, Ahmed N, et al. Outcome of emergency coronary artery bypass grafting. J Cardiothorac Vasc Anesth. 2015 Apr;29(2):275–82.
19. Howell NJ, Head SJ, Freemantle N, van der Meulen TA, Senanayake E, Menon A, et al. The new EuroSCORE II does not improve prediction of mortality in high-risk patients undergoing cardiac surgery: a collaborative analysis of two European centres. Eur J Cardiothorac Surg. 2013 Dec;44(6):1006–11; discussion 1011.
20. Guida P, Mastro F, Scrascia G, Whitlock R, Paparella D. Performance of the European System for Cardiac Operative Risk Evaluation II: a meta-analysis of 22 studies involving 145,592 cardiac surgery procedures. J Thorac Cardiovasc Surg. 2014 Dec;148(6):3049-3057.e1.

Similar Articles

You may also start an advanced similarity search for this article.