Percutaneous coronary intervention decreased predicted mortality more than CABG at 30 days (6.48% vs 2.33%) and 5 years (3.45% vs 3.30%) in an AI-based model of dialysis patients with ACS.
Observational (n=60,491)
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Does PCI reduce mortality compared to CABG in dialysis patients with acute coronary syndrome?
A deep neural network model predicts that PCI has a greater effect on reducing mortality compared to CABG from 30 days to 5 years in dialysis patients with acute coronary syndrome.
Introduction: Due to retrospective data and the exclusion of patients with kidney failure in clinical trials, the ability to predict mortality in patients with acute coronary syndrome (ACS) receiving dialysis is limited, particularly in females, by the type of revascularization (Percutaneous Coronary Intervention PCI and Coronary Artery Bypass Graft CABG).Methods: Using the United States Renal Data System, 51 clinical and demographic features were extracted from 60,491 dialysis patients with acute coronary syndrome.The performance of an artificial intelligencebased mortality prediction model in dialysis patients by revascularization strategy type and sex from 30 days to 5 years after the first acute coronary syndrome hospitalization, based on precision, recall, F1 score, and area under the receiver operating curve (AUROC).Stratified random sampling was employed with an 80-20 split and a 3-fold crossvalidation.Five machine learning models and one deep learning model were trained and evaluated.Results: The gradient-boosting machine learning model outperformed other models with an AUROC between 0.6532 and 0.7898.The deep neural network had the highest F1 score, achieving 0.9299 at the 5-year prediction.At 30 days, PCI decreased predicted mortality by 6.48%, while CABG decreased predicted mortality by 2.33%.At 5 years, PCI decreased the predicted mortality by 3.45%, while CABG decreased the predicted mortality by 3.30%.In both males and females, from 30 days to 5 years, PCI led to the greatest decrease in predicted mortality, while no treatment led to the greatest increase in predicted mortality. Conclusion:This study is the first to develop an artificial intelligencebased mortality prediction model for patients with acute coronary syndrome undergoing dialysis.The deep neural network showed the best overall performance.PCI had a greater effect on reducing predicted mortality as compared to CABG from 30 days to 5 years in both males and females with acute coronary syndrome undergoing dialysis.I have potential conflict of interest to disclose.
Shah et al. (Wed,) conducted a observational in Acute coronary syndrome in patients with kidney failure receiving dialysis (n=60,491). Percutaneous Coronary Intervention (PCI) vs. Coronary Artery Bypass Graft (CABG) and no treatment was evaluated on Mortality prediction from 30 days to 5 years. Percutaneous coronary intervention decreased predicted mortality more than CABG at 30 days (6.48% vs 2.33%) and 5 years (3.45% vs 3.30%) in an AI-based model of dialysis patients with ACS.